Obes Surg. 2026 Jul 25. doi: 10.1007/s11695-026-08800-4. Online ahead of print.
ABSTRACT
BACKGROUND: Laparoscopic Sleeve Gastrectomy (LSG) is the most frequently performed technique among bariatric surgical procedures; however, it may lead to aesthetic concerns due to visible port scars. The primary objective of this study is to compare the safety, efficacy, and cosmetic outcomes of the Modified Bikini Line Sleeve Gastrectomy (MBLSG) technique-which we have defined to address this drawback-with conventional LSG.
METHODS: Patients who underwent MBLSG and conventional LSG at the participating centers between 2020 and 2025 were retrospectively analyzed. A total of 1834 patients (Conventional LSG: 928; MBLSG: 906) were included in the study. The two groups were compared based on demographic data (age, sex, BMI, ASA score), operative time, complication rates (according to the Clavien-Dindo classification), postoperative pain scores (VAS), and weight loss percentages (%TWL, %EWL) at the 3rd, 6th, and 12th months.
RESULTS: Significant differences were observed between the groups in terms of age (35.8 ± 6.7 vs. 34.5 ± 6.8 years; p < 0.001) and sex distribution (p < 0.001, with a significantly higher proportion of female patients in the MBLSG group). However, no significant differences were found regarding mean body mass index (BMI), body weight, or ASA score distribution (p > 0.05). The operative time in the MBLSG group (26.9 ± 3.4 min) was longer than that in the conventional group (23.1 ± 3.2 min; p < 0.001). Regarding complication rates, the Grade I complication rate was significantly higher in the MBLSG group (27.0%) compared to the conventional group (25.1%), as was the Grade II complication rate (15.1% in MBLSG vs. 12.0% in conventional; p = 0.049). Analysis of weight loss percentages (at 3, 6, and 12 months) revealed no statistically significant difference between the groups (p > 0.05). The groups also exhibited similar results for early postoperative parameters such as pain levels (VAS) and time to mobilization. Conversely, when postoperative cosmetic scores were evaluated, the level of patient satisfaction was significantly higher in the MBLSG group than in the conventional LSG group.
CONCLUSION: Despite a minimal extension in operative time and a slight increase in the risk of minor, medically manageable complications (specifically surgical site infections and ecchymosis), MBLSG is a safe, clinically effective, and feasible bariatric surgical approach for selected patients who prioritize cosmetic benefits and aesthetic satisfaction.
PMID:42498877 | DOI:10.1007/s11695-026-08800-4
