Several reports have discussed the potential for reducing port access in laparoscopic sleeve gastrectomy (LSG); however, each approach had its innate setbacks. Aiming at improving the aesthetic outcome, we report a novel approach to the LSG where we place the trocars at the bikini line in what we described as bikini line sleeve gastrectomy (BLSG).
The present work is a prospective, pilot study on the use of BLSG in patients, during the period between April and October 2016. Exclusion criteria included the following: large hiatal hernia, upper abdominal surgery, and xiphi-umbilical, xiphi-symphysis pubis, and xiphi-anterior superior iliac spine distances of > 25,36 and 33 cm, respectively. Four trocars were used: one at the umbilicus and three at the bikini line. All laparoscopic graspers were bariatric length instruments (43 cm). However, camera telescope, endoscopic stapler, and bipolar dissectors were standard length.
Twenty eight patients underwent BLSG. The mean age was 34.6 ± 3.7 years with a mean BMI of 42.46 kg/m2 ± 3. There were no major intra- or postoperative complications and no conversion to conventional port site placement. Patient’s scar satisfaction was favorable. The mean postoperative BMI and weight at 6 m were 28.5 ± 1 kg/m2 and 79.8 kg ± 2, respectively. The mean percentage excess weight loss at 3, 6, and 12 months were 39.5 ± 4.6, 64.5 ± 5, and 69.8 ± 6%, respectively.
BLSG was found to be potentially safe, feasible, and effective with a favorable aesthetic outcome; it could possibly be offered to a select group of patients that are conscious about their scar appearance.
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Conflict of Interest
The author declares that he has no conflict of interest.
Statement of Informed Consent
Informed consent was obtained from all individual participants included in the study.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Abdelbaki, T.N. Bikini Line Sleeve Gastrectomy: Initial Report. OBES SURG 27, 3320–3326 (2017). https://doi.org/10.1007/s11695-017-2941-x
- Sleeve gastrectomy
- Minimal scar
- Bikini line
- Less invasive
- No scar