title: Laparoscopic cholecystectomy on the bikini line for invisible scar.
abstract: BACKGROUND
  A traditional laparoscopic cholecystectomy uses 4 trocar incisions on the upper abdomen, which may be the source of undesirable cosmetic outcomes. We describe here a modification of the traditional laparoscopic cholecystectomy by which scars remain underwear. Supplemental Digital Content 1, http://links.lww.com/SLE/A27.
  
  
  METHODS
  A 32-year-old woman and 43-year-old man with symptomatic cholelithiasis were chosen for laparoscopic cholecystectomy on the bikini line. Four trocar were used, all of them were positioned at the lower abdomen in the same parallel on the bikini line. All procedure was performed with standart laparoscopic instrumentation. Gallbladder was removed through the median suprapubical trocar site.
  
  
  RESULTS
  Both procedures were technically successful with no skin incisions outside the bikini line. The total operation times were: 65 and 45 minutes, and the hospital stay were 2 days. There were no complications during or after surgery. We left no scar on the upper abdomen.
  
  
  CONCLUSIONS
  Laparoscopic cholecystectomy on the bikini line is technically feasible, safe, and effective. There is no need for learning curve and extralaparoscopic instrumentation. The major advantage of this method is improved cosmetic outcome with no visible abdominal scars. This new technique carries the potential to be an option for the traditional laparoscopic cholecystectomy.
authors.affiliation: Department of General Surgery, Istanbul Education and Research Hospital, Istanbul, Turkey. feyzullahersoz@gmail.com
authors.forename: Feyzullah
authors.initials: F
authors.lastname: Ersoz
authors.forename: Ozhan
authors.initials: O
authors.lastname: Ozcan
authors.forename: Serkan
authors.initials: S
authors.lastname: Sari
authors.forename: Hasan
authors.initials: H
authors.lastname: Bektas
authors.forename: Soykan
authors.initials: S
authors.lastname: Arikan
mesh_terms: D000328:Adult; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods*; D017439:Cicatrix, Hypertrophic / Q000209:etiology / Q000517:prevention & control*; D003020:Clothing; D003358:Cosmetics; D005260:Female; D005704:Gallbladder / Q000601:surgery*; D006801:Humans; D008297:Male; D010149:Postoperative Pain / Q000517:prevention & control; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D013525:Surgical Instruments; D013550:Swimming
chemical_list: D003358:Cosmetics