[A comparative study on early incision adaptability between symmetric and right-sided three-port laparoscopic bariatric surgery].

Objective

To compare early postoperative incision outcomes between patients undergoing laparoscopic bariatric surgery with right-sided three-port versus symmetric three-port placement.

Methods

A multicenter retrospective cohort study was conducted. A total of 201 patients who underwent three-port laparoscopic bariatric surgery between December 2024 and April 2025 were enrolled (116 from the Third Peoples's Hospital of Chengdu and 85 from the First Affiliated Hospital of Jinan University), including 116 cases in the right-sided three-port group and 85 cases in the symmetric three-port group. The Patient and Observer Scar Assessment Scale, 3rd Version (POSAS 3.0) and Body Image and Appearance Questionnaire (BODY-Q) were used to evaluate scar quality and psychological adaptation, respectively. Postoperative scar quality, adaptation to scars, and early postoperative complaints related to incision concerns were compared between the two groups.

Results

No statistically significant differences were observed in baseline characteristics between the two groups(all P>0.05). There were no significant differences in the total POSAS score or any individual item scores (all P>0.05), except for significantly lower itching scores in the right-sided three-port group(1.91±0.98 vs. 2.25±1.42, t=-2.020, P=0.045). Compared with the symmetric three-port group, the right-sided three-port group exhibited significantly better total BODY-Q scores, physical attributes (location, visibility, color, length, and distortion), psychosocial aspects (concern about being noticed by others, concealment), and a significantly lower incidence of overall early discomfort complaints (all P<0.05).

Conclusions

Based on patients' early postoperative subjective experience, right-sided three-port laparoscopic bariatric surgery is associated with a lower rate of overall incision-related complaints and better psychological adaptation to surgical scars.