Abstract
Relevance. Adhesive small bowel obstruction is a common surgical emergency associated with substantial morbidity and frequently requires operative treatment. Although multi-port laparoscopy is widely accepted, evidence regarding the safety and feasibility of single-port laparoscopic surgery remains limited. Objective: To evaluate the feasibility, safety, and perioperative outcomes of single-port laparoscopic surgery in the management of adhesive small bowel obstruction. Materials and Methods. This was a retrospective, multicenter, single-arm observational study conducted from April 2018 to October 2025 and included 91 patients with adhesive small bowel obstruction. All patients were operated on by one surgeon laparoscopically using the single-port technique (single-port laparoscopic surgery). The effectiveness of single-port laparoscopic surgery was assessed by analyzing operative time, intraoperative and postoperative complications, length of hospital stay, incision length, and intraoperative blood loss. Results. In this selected cohort, all 91 patients underwent SPLS without conversion to multi-port laparoscopy or open surgery. Postoperative complications occurred in 5 patients, corresponding to an incidence of 5.5 % (95 % CI: 1.8–12.4). Favorable outcomes were likely associated with careful patient selection and surgeon expertise, despite the technical challenges of the single-port approach. These findings suggest that SPLS may be a feasible minimally invasive approach in selected ASBO patients when performed by an experienced surgeon. Conclusions. The findings suggest that SPLS is technically feasible and potentially safe in carefully selected patients with ASBO when performed by an experienced surgeon. However, prospective comparative studies are required to confirm its advantages over conventional laparoscopic or open approaches.