Research Information System
Obesity Surgery, 2026 (SCI-Expanded, Scopus)
Background: The Bikini-line sleeve gastrectomy is a modification of standard laparoscopic sleeve gastrectomy designed primarily to improve aesthetic outcomes by relocating trocars to the lower abdomen. It offers aesthetic advantages without additional metabolic or functional benefit. Purpose: The study compared early clinical outcomes, pain, scar satisfaction, and post-operative pain between Bikini-line sleeve gastrectomy and standard laparoscopic sleeve gastrectomy. Materials and methods: This retrospective cohort study of 364 patients: 216 in laparoscopic sleeve gastrectomy and 148 in bikini line sleeve gastrectomy operated from January 2023 to December 2023. Demographics, operating time, length of hospital stay, excess weight loss, pain scores, scar satisfaction, and complications have been assessed. Patients with BMI ≥ 30 kg/m² with T2DM, BMI 35–39.9 kg/m² with comorbidities, and BMI ≥ 40 kg/m² were included. However, patients with a progressive history of a major open abdominal surgery, persistent hiatal hernia of more than 4 cm, and patients who refused to use the bikini-line method were excluded. The study applied the Kolmogorov-Smirnov test to ascertain the normality of the data. Student’s t-test was used for normally distributed variables, and the Mann–Whitney U test for non-normally distributed ones. Chi-square and Fisher exact tests ensured stable examination of operative time, pain, scar satisfaction, EWL, and complications. Results: The laparoscopic sleeve gastrectomy group had a higher preoperative BMI (42.49 ± 6.19 vs. 38.52 ± 4.72, p < 0.001). No significant differences were observed in excess weight loss % at 3, 6, and 12 months between laparoscopic sleeve gastrectomy and bikini-line sleeve gastrectomy (35.8% vs. 35.9%, p = 0.667; 49.6% vs. 49.2%, p = 0.356; 56.0% vs. 56.3%, p = 0.390). Postoperative 12 h pain was significantly lower in the bikini line sleeve gastrectomy group (4.14 ± 0.78 vs. 5.35 ± 1.02, p < 0.001), while scar satisfaction scores at discharge and at 12 months were markedly higher (p < 0.001). Complication rates (bleeding p = 0.149; thromboembolism p = 1.000; infection p = 0.125) and operation times (p = 0.131) were similar between groups. Conclusion: Bikini-line sleeve gastrectomy demonstrated comparable weight loss and complication rates to standard laparoscopic sleeve gastrectomy, while significantly reducing early postoperative pain and improving scar satisfaction. Although feasible and safe in selected patients with appropriate closure, Bikini-line sleeve gastrectomy is primarily an aesthetic adaptation rather than a replacement for standard laparoscopic sleeve gastrectomy.