Background

Improved trocar site cosmesis is a desired outcome after laparoscopic surgery. Bariatric patients undergoing laparoscopic surgery have port sites that can be closed with inferior cosmetic results if proper technique is not used. We describe an inexpensive, simple, and reliable technique for adequate bariatric trocar site closure and prevention of port site skin dimpling. This technique was studied as a retrospective consecutive case series. The technique was used for closing the fascia of a single 12mm periumbilical port site in 117 consecutive bariatric laparoscopic cases. An endo fascial closure device was used to close the port site in a figure of eight fashion under direct visualization. Incisional hernia and dimpling were assessed at mean follow up times of 2 weeks, 3 months and 1 year. The technique was used on 117 bariatric laparoscopic port sites with no incidence of incisional hernia or dimpling at a mean follow up time of 2 weeks, 3 months and 1 year by surgeon physical exam. No additional instrumentation or port sites were used. No intraoperative incidents, bowel injuries or additional OR time was reported. The technique is a simple, effective and reliable way to close bariatric laparoscopic port sites and prevent dimpling.