Adam Kay appears from backstage, tops up the wine glass sat on his piano, emptying one bottle and cracking open a another, then plonks himself down at the piano and rattles out a couple of opening song/gags about Edinburgh to the tune of Starship's We Built This City changed to, 'They built this city on a maaasssiiiivve hiiiilll.'

Opening with material about the town in which they're playing is a regular opening gambit for a stand-up and there's no reason why Kay, just because he's got a piano in front of him, shouldn't begin his show like that too. But when he continues his shtick, essentially changing the lyrics to songs slickly but simplistically, you begin wonder how he's going to stretch it out for an hour. But he does and, as it turns out, it doesn't feel stretched at all.

There's a kind of narrative arc, I say 'kind of' as you're not sure whether it's deliberate or might just be the result of the couple of bottles of wine he's necked by the end of the show.

Kay continually bemoans his parents' disappointment in him not sticking with his career in medicine. He moves on to rail at Chortle's previous description of his act as being 'artistically bankrupt' and the outcry results in a broken wine glass, but then just as swiftly he's banging out the next number and consoling himself by flirting with the attractive boy in the front row.

Should any of these insecurities be truly based in reality he really has no reason to harbour them, as he's playing in front of a sell out crowd in the Pleasance Forth which has a capacity of a few hundred. Kay built up a following alongside his Amateur Transplants partner Dr. Suman Biswas, whom he met while medical students.

Their London Underground song venting frustrations at the Tube strikes in 2005 to the tune of The Jam's Going Underground became an internet hit and they've been playing to audiences at the Fringe for the six years since. This year Kay's gone solo, and the diarrhoea songs and other below-the-belt numbers that prompted the 'artistically bankrupt' reference are relegated to a corner of the set and supplemented by considerably better gags.

A stand-out example for its sheer simplistic silliness is Lady Gaga's Poker Face reworked as a warning against drinking a cup of tea with the spoon left in it. Elsewhere there's an enjoyable running gag that involves a small puzzle for the audience who have to guess how he's going to change the chorus of Leonard Cohen's Hallelujah? 'Alloy loofah' anyone?

Maybe there's more to Kay than smutty songs after all.