Hidden Scar Bikini Laparoscopic Cholecystectomy for Overweight and Obese Patients - Randomized Clinical Trial

Background: Bikini line laparoscopic cholecystectomy is a safe method, used as a hidden scar cosmetic port technique for gall bladder diseases in obese patients as a day case. Objective To investigate the safety and efficacy of an elective Bikini line laparoscopic cholecystectomy in obese patients with chronic calculus cholecystitis and review our experience with this technique as a day case minimal invasive, scarless technique. Patient and method A Prospective randomized controlled trial study was undertaken between January 2017 and February 2021. The sample consisted of 480 patients, of which only 416 were analyzed, 216 patients underwent multi-port laparoscopic cholecystectomy, and 200 patients underwent Bikini Line laparoscopic cholecystectomy at two institutes. Procedures were performed under general anesthesia, and most of the cases underwent day-case surgery. The variables to be analyzed were operative time, the success of day case and length of stay, conversion rate, complications, pain scoring, and aesthetic results. BMI fell to between 25 to 39.9Kg/m2. Results: No differences were found between both groups about the baseline characteristics. Bikini line laparoscopic cholecystectomy achieved the target of one-day case surgery with better, faster recovery and reduced length of stay. Operative time was nearly the same, postoperative pain was significantly lower, and Cosmoses was better. Conclusion: Bikini Line laparoscopic cholecystectomy is a technically safe and effective day surgery procedure for chronic cholecystitis patients, with higher patient satisfaction about pain and cosmoses. Obesity, intended as BMI 40, is not an obstacle to the technical feasibility of BLLC.