Laparoscopic Bikini Line Sleeve Gastrectomy Sleeve gastrectomy

Abstract

Background/Introduction: Among various bariatric procedures, laparoscopic sleeve gastrectomy (LSG) became one of the most frequently performed surgeries for treatment of morbid obesity. The procedures become less invasive as the size of ports is reduced, while maintaining the extent of surgery and maintaining patients satisfaction with cosmetic results. It is advisable to take cosmetic results into consideration in the field of bariatric surgery as much as possible, as most patients are not happy with their scar’s appearance, most of them adopt different coping behaviours to hide or compensate them. The ports during the bikini line sleeve gastrectomy (BLSG) are placed at the lower abdomen in order to make the port scars aesthetically acceptable. The patients feel less pain after the bikini line sleeve gastrectomy, although this requires more data to make final conclusions. The purpose of this report is to describe our initial experience of the BLSG operation. Objectives/Results: We used inclusion criteria to find suitable patients for this bariatric surgery technique. The criteria includes the following: the height up to 170 cm, the body mass index (BMI) between 35 and 50 kg/m2, no large hiatal hernia, no previous upper abdominal surgery, and respectively xiphoid- umbilicus, xiphoid-symphysis pubis, and xiphoid-anterior superior iliac spine distances are less than 25, 36, and 33 cm The patient supine in split leg position and properly secured to the operating table with the use of special braces in the lower limbs. The angle of leg splitting was slightly different compared to classic laparoscopic sleeve gastrectomy. In BLSG, the left leg is more straight, compared to the right leg, because of the smaller angle the surgeon achieves better ergonomy during suturing phase. The main surgeon was positioned between the patient’s legs, the assistant on the main surgeon’s right, while the scrub nurse on his left side. The patient was placed in the fat position and then 45-degree reverse Trendelenburg once ports have been placed. The bikini sleeve gastrectomy involves the same three phases as classic laparoscopic sleeve gastrectomy, such as gastric mobilization, stapling, and suturing phases. Conclusion: The surgical technique of BLSG is safe and effective if performed correctly. The mean operative time performing bikini line sleeve gastrectomy is close to standard sleeve gastrectomy.