Assessing the Safety and Aesthetic Benefits of Reduced Port Bikini-Line Sleeve Gastrectomy (RBSG): An Initial Report

Obesity significantly increases the risk of chronic conditions and has profound psychological effects. While conventional laparoscopic sleeve gastrectomy (CLSG) effectively addresses these issues, concerns about visible scarring remain. Reduced port bikini-line sleeve gastrectomy (RBSG) was introduced to enhance cosmetic outcomes by repositioning ports along the bikini line, potentially improving body image satisfaction.

This prospective cohort study included 118 patients who underwent RBSG at a single institution between September 2022 and September 2023. The study evaluated operative time, intraoperative complications, postoperative pain, port-site complications, and body image perception using the body image scale (BIS). Propensity score matching was applied to mitigate confounding variables, and statistical analyses included paired t-tests and non-parametric alternatives as appropriate.

The mean operative duration was 48.97 ± 8.51 min, with a 1.7% incidence of inferior epigastric artery injury, effectively managed intraoperatively. Port-site hernias and surgical site infections occurred in 1.7% and 3.4% of cases, respectively. BIS scores improved significantly from 18.58 ± 1.87 preoperatively to 11.44 ± 1.99 postoperatively (p < 0.001), indicating enhanced body image perception. Pain scores remained low at 6 and 12 h postoperatively, and no significant correlation was found between pain levels and port-site complications.

RBSG is a safe and effective alternative to CLSG, offering equivalent weight loss and safety profiles while significantly improving postoperative body image perception. The technique maintains technical feasibility without compromising operative time or increasing complications. Larger, multicenter studies with extended follow-up are warranted to validate these findings and assess the long-term sustainability of the observed benefits.