Alternative port site selection (APSS) for improved cosmesis in laparoscopic surgery

The use of laparoscopy can be associated with improved cosmesis following a variety of gastrointestinal procedures versus standard open surgery. The placement of laparoscopic ports in less visible areas of the body such as the bikini line, termed alternative port site selection (APSS), may result in further improved cosmesis. Performance of laparoscopic procedures from such alternative port placement areas may be associated with increased technical challenge. This manuscript discusses APSS approaches for two common laparoscopic procedures, cholecystectomy and gastric banding. Familiarity and implementation of these techniques can allow select patients to undergo procedures with less visible scarring and is less challenging than laparoscopic single site approaches.