Single site laparoscopic simultaneous cholecystectomy, sleeve gastrectomy, and paraumbilical hernia – First case report

•First report of multiple procedures performed through single site.•Complex single site surgery performed without the use of port assistive device.•Cosmetically superior procedure.•Single incision multiport.•Reduced post operative pain, reduced length of hospital stay and cost effective. Single site surgery is rapidly gaining popularity for its cosmetic benefits. However it requires immense technical skill due to its challenging ergonomics.We have reported here a case where multiple surgeries have been performed through the same single site,without the usage of special devices.This article has been reported in line with the SCARE criteria [1]. A 45-year-old obese lady presented with symptomatic cholelithiasis and a para umbilical hernia. She underwent uneventful trans umbilical, single site laparoscopic cholecystectomy, sleeve gastrectomy and paraumbilical hernia repair. This article is being published as it is the first reported from the Middle East. Recent development of laparoscopy was represented with introduction of the concept of scarless surgery using Natural Orifice Transluminal Endoscopic Surgery (NOTES), or its Transumbilical counterpart (NOTUS). Unfortunately,these two approaches have not been widely reported, probably due to the need for specialized instruments, learning curve, and prolonged surgery time [2]. This single case report is to indicate that it is technically possible and cosmetically appealing to perform such a complex surgery.