A single-incision sleeve gastrectomy, also known as SILS (Single Incision Laparoscopic Surgery), is an innovative approach to weight-loss surgery that offers potential advantages, but it also carries specific risks and considerations. This technique involves performing the entire procedure through a single incision, typically in the umbilical area, which can result in reduced scarring and potentially faster recovery compared to traditional multi-port laparoscopic surgery. In terms of risks, single-incision surgery may pose technical challenges for the surgeon due to limited visualization and maneuverability, which can slightly increase the risk of complications, such as bleeding or leaks. However, in the hands of an experienced bariatric surgeon, these risks are typically well-managed. It’s essential to ensure that the surgeon performing the procedure is highly skilled in this specific technique. The single-incision sleeve is primarily performed in first-time surgeries, as the anatomy is more predictable in these cases. For revision procedures, such as converting from a gastric band to a sleeve gastrectomy, the complexity of the surgery increases, especially if the band has already been removed and there is scar tissue or altered anatomy. While it may be technically possible to perform a revision as a single-incision procedure, most surgeons prefer traditional multi-port laparoscopic approaches for better access and safety in such cases. Regarding the number of ports used in laparoscopic surgery, it varies depending on the surgeon’s preference and the complexity of the procedure. While five ports are standard in many cases, some surgeons successfully use three or four ports, depending on their experience and the patient’s anatomy. Single-incision surgery represents an even more advanced variation of this, requiring specialized skills and equipment.