Early and Late Trocar-Site Outcomes After Laparoscopic Sleeve Gastrectomy Using a Standardized Fascial Closure Technique: a Prospective Observational Study.

BACKGROUND

Trocar-site complications after laparoscopic metabolic bariatric surgery are uncommon but may result in clinically relevant morbidity. Standardized fascial closure of trocar sites, particularly in patients with obesity, has been proposed as a strategy to minimize early and late postoperative complications.

OBJECTIVE

To describe early and late clinically assessed trocar-site outcomes following laparoscopic sleeve gastrectomy in a consecutive cohort managed with a standardized 12-mm fascial closure protocol.

METHODS

A prospective observational study was conducted. Consecutive adult patients undergoing laparoscopic sleeve gastrectomy between February 2023 and August 2024 were enrolled. Fascial closure of the 12-mm trocar site was performed using a standardized institutional technique. Clinical follow-up was conducted at 6, 12, and 18 months. Early outcomes included trocar-site pain, infection, seroma, hematoma, and bleeding. Late outcomes included chronic pain, trocar-site hernia, and neuralgia. Descriptive statistical analyses were performed.

RESULTS

A total of 125 patients were enrolled, of whom 118 completed the 18-month follow-up and were included in the analysis. Mean age was 42.4 ± 11.9 years, and mean body mass index was 38.6 ± 5.3 kg/m². Early postoperative complications were infrequent. Trocar-site pain was reported in four patients (3.4%) and was predominantly mild in severity. No cases of infection, seroma, hematoma, or bleeding were observed. During follow-up, no clinically detected late trocar-site complications, including trocar-site hernia, chronic pain, or neuralgia, were identified.

CONCLUSION

In this prospective single-center observational cohort, clinically assessed early trocar-site events were infrequent, and no clinically detected late trocar-site events were observed through 18 months of follow-up. These findings are descriptive and hypothesis-generating; comparative studies are required to determine whether standardized closure techniques or specific devices confer benefit over alternative strategies.