Abstract
Background/Objectives: Single-port laparoscopy represents a significant advancement in minimally invasive surgical techniques and is designed to reduce surgical trauma and enhance cosmetic outcomes. However, ongoing debate surrounds its relative benefits and limitations as compared with conventional multi-port laparoscopy. This study systematically reviewed and analyzed comparative outcomes between these two approaches. Methods: We conducted a comprehensive systematic search of major electronic databases from January 2000 to October 2023, following PRISMA guidelines. Only randomized controlled trials comparing single-port laparoscopy with conventional laparoscopy were included. We analyzed operative outcomes, postoperative recovery parameters, complications, and patient-reported measures using random-effects models, with heterogeneity explored through subgroup analyses. Results: Forty-three randomized controlled trials involving 5807 patients were analyzed. Single-port laparoscopy demonstrated longer operative times (weighted mean difference: +10.5 min; 95% CI: 7.83-13.18; p < 0.001), superior cosmetic satisfaction (standardized mean difference: +0.61; 95% CI: 0.39-0.83; p < 0.001), and reduced postoperative pain within 24 h (standardized mean difference: -0.58; 95% CI: -0.95 to -0.21; p = 0.002). The overall complication rates showed no significant differences (risk ratio: 0.94; 95% CI: 0.78-1.14; p = 0.31), though incisional hernia risk increased with single-port laparoscopy (odds ratio: 2.26; 95% CI: 1.23-4.15; p = 0.009). Conclusions: Single-port laparoscopy offers meaningful improvements in cosmetic outcomes and early pain relief, balanced against longer operative times and increased hernia risk. The substantial heterogeneity observed underscores the importance of surgeon experience, appropriate patient selection, and optimal technique selection in determining outcomes.