Bikini Line Research Articles

Bikini line one-anastomosis gastric bypass (BLOGB): initial report

BackgroundThis study introduces a new access method for one-anastomosis gastric bypass (OAGB) by placing ports at the bikini line.ObjectiveTo describe our initial experience and assess the feasibility, safety, and effectiveness of this novel access.SettingUniversity Hospital.MethodsThis prospective case–control study included 72 patients: 42 were allocated to the bikini line one-anastomosis gastric bypass (BLOGB) group, and 30 were assigned to the control group. Exclusion criteria included a history of major abdominal surgery, hiatal hernia, extensive lower abdominal adhesions, or a body mass index (BMI) exceeding 55 kg/m2.ResultsThe mean preoperative BMI of the study sample was 40.01 ± 2.84. Weight loss was satisfactory, with the highest percent excess weight loss (%EWL) observed at 12 months: 90.88 ± 7.90 and 91 ± 7.11 (p = 0.474) in both groups, respectively. Both groups showed no significant differences in operative complications, hospital stay, weight loss, or resolution of obesity-associated diseases. However, the BLOGB patients had a longer mean operative time of 110.71 ± 17.72 min compared to 98 ± 18.27 min in the control group (p = 0.002). Moreover, they experienced less postoperative pain and reported greater satisfaction with the appearance of their scars.ConclusionBLOGB was found to be potentially feasible, safe, and effective, offering improved aesthetic outcomes and reduced postoperative pain. This approach may be suitable for a select group of patients concerned with scar appearance. However, large-scale studies are necessary to ensure that safety is not compromised in pursuit of aesthetic benefits.

The first robotic-assisted hysterectomy below the bikini line with the Dexter robotic system™.

Robotic-assisted hysterectomy (RAH) is a widely accepted minimally invasive approach for uterus removal. However, as RAH is typically performed in the umbilical region, it usually results in scars in cosmetically suboptimal locations. This is the first case of RAH with cervicosacropexy performed below the bikini line, using the new Dexter robotic system™. The aim of this article is to show the surgical steps of the first RAH with cervicosacropexy performed below the bikini line with the new Dexter robotic system™ (Distalmotion), and furthermore assess the feasibility of this approach using this robotic platform. A 43-year-old woman with uterine adenomyosis and recurrent uterine prolapse underwent a robotic-assisted subtotal hysterectomy with cervicosacropexy, performed below the bikini line, using the Dexter robotic system™, at the Clinic of Gynecology and Obstetrics at Universitätsklinikum Schleswig-Holstein (UKHS) in Kiel, Germany. Perioperative data, surgical approach specifics, objective, and subjective outcomes of this new approach. The procedure was performed without intra-operative complications; estimated blood loss was 10 ml. Operative time was 150 minutes, console time 120 minutes, total docking time 6 minutes. Dexter performed as expected; no device-related issues or robotic arm collisions occurred. The patient did not require pain medication and was released on the second postoperative day. RAH performed below the bikini line using the Dexter robotic system™ is a feasible, safe, and adequate procedure. These initial results should be confirmed and further extensively refurbished with larger patient cohorts, and functional and psychological outcomes need further investigation.

IBC-Oxford University2023_BJSOral_21Video Presentation: Bikini Line Access in Bariatric Surgery - 8 years’ experience

Abstract Laparoscopic bariatric surgery is constantly advancing to minimize surgical trauma and enhance cosmetic outcomes, particularly among young women and patients who are concerned about the appearance of their scars. In line with this, we developed the Bikini Line Sleeve Gastrectomy (BLSG) approach to make the port site scars from LSG less noticeable. This approach involves placing the trocars at the lower abdomen, along the curved line just above the symphysis pubis. The aim of this placement is to achieve a more aesthetically pleasing outcome, as the scars are concealed within the bikini line. During the implementation of the BLSG technique, it was observed that some patients would come back with gallstones. So we started performing Bikini Line Cholecystectomy. Furthermore, some patients also had a concurrent hiatal hernia that needed to be addressed. The challenge was to perform the hiatal hernia repair using the same access points without compromising the safety or efficiency of the repair. Finally, we started exploring the bikini line access during one anastomosis gastric bypass.

Bikini-line Hiatal Hernia Repair (BLHHR) During Sleeve Gastrectomy

BackgroundTo preserve the aesthetic benefits achieved with Bikini line sleeve gastrectomy (BLSG), we have devised a novel approach for simultaneous hiatal hernia repair (HHR), known as bikini-line hiatal hernia repair (BLHHR). This manuscript presents our initial experience with BLHHR and assesses its feasibility and outcomes.MethodsA prospective preliminary study was conducted on patients who underwent BLHHR between September 2020 and October 2022. Patient demographics, preoperative assessments, operative details, postoperative outcomes, and aesthetic evaluations were recorded. Feasibility and safety were assessed.ResultsAmong 891 BLSG patients, 89 (9.9%) underwent BLHHR. The mean distances between the xiphoid process and the umbilicus, symphysis pubis, and anterior superior iliac spine (ASIS) were 28.8 ± 2.2, 33.9 ± 3.1, and 31.2 ± 1.8 cm, respectively. Optimal visualization and accessibility of the gastroesophageal junction (GEJ) were achieved without compromising HHR repair or sleeve gastrectomy. The mean operative time was 76.5 ± 11 min, longer than the 58 ± 10 min required for BLSG alone. Patient scar satisfaction ranged from 87.5 to 97.9%, and the mean pain score was 2.9 ± 0.8. No major complications were reported. At 6 months, %EWL (percentage of excess weight loss) was 53.3 ± 13.7%, GERD (gastroesophageal reflux disease) remission was achieved in 62.8% of patients and comorbidities were improved.ConclusionBLHHR was potentially feasible and safe. Outcomes related to patient scar satisfaction, weight loss, improvement of associated comorbidities, and GERD symptoms were not compromised. The aesthetic benefits achieved by BLSG were maintained.Graphical

A multicentric, prospective, observational study evaluating the practice pattern and use of fixed dose topical regimen for hyperpigmentation in intimate and high friction areas

Background: Hyperpigmentation is the third most common dermatological disorder and has major psychosocial impairment. It comes in a variety of forms. The most well-known are age spots, freckles, melasma and post-inflammatory hyperpigmentation. Hyperpigmentation in friction-prone areas (armpits, inner thighs, elbows, knees, groin, etc.) has a significant impact on affected individuals. Unfortunately, there are currently no well-tolerated options available that are intended particularly for these sensitive areas. Methods: Dermatologists across India were provided a questionnaire consisting of questions related to number of the patients seen with hyperpigmentation in intimate & high friction areas every week and their clinical experience regarding the use of Pigmentbio Sensitive areas containing active ingredients (Andrographolide+Glabridin+Lysine azelate+Laminaria ochroleuca extract). The results were analyzed using a visual analogue scale. Results: The study included a total of 1402 patients, and 75 dermatologists provided complete responses. The majority (96%) of the dermatologists recommended Pigmentbio Sensitive areas for intimate & high friction areas. These dermatologists also rated tolerability and safety of Pigmentbio Sensitive areas as "excellent" to "good" based on various criteria. These included tolerability after waxing and shaving the bikini line, soothing effect after mechanical erythema from taking off tight clothing, hydrating power when compared to other products, cosmetic acceptability for frictional and intimate areas, and safety on intimate areas. Conclusions: This study findings indicated that Pigmentbio Sensitive areas is a preferred formulation by dermatologists across India for the management of hyperpigmentation in intimate & high friction areas with proven tolerability and safety.

Safe and Aesthetic; Laparoscopic Cholecystectomy on The Bikini Line

Objective: Laparoscopic cholecystectomy (LC) is the gold standard treatment for symptomatic cholelithiasis and is the most commonly performed surgical procedure worldwide. It is superior to open cholecystectomy in terms of aesthetics, but the visibility of the trocar ports is a cosmetic problem due to increasing aesthetic concerns. We report the results of patients who underwent conventional four port LK with all incisions below the bikini line.
 Material and Method: The study included patients who underwent LK through bikini incision in our clinic between 01.11.2020 and 31.11.2021. Age, gender, comorbidities, indications for cholecystectomy, previous abdominal surgeries, anesthesia scores, and body mass index (BMI) were recorded. The procedure was not performed in patients undergoing emergency surgery for acute cholecystitis and other causes.
 Results: The study included 9 patients, all of whom were female. The mean age was 30 ± 7.8 years and mean BMI was 23.1 ± 4.3. Mean operative time was 33.9 ± 8.5 minutes. Open operation was not performed in any patient. The hospitalization period was one day for all patients. There were no complications in any of the patients. Eight of the nine patients (89%) expressed cosmetic satisfaction in the first month after surgery.
 Conclusion: The prevalence of LC leads to an increase in the number of patients expecting less scarring. Here, we propose a modified four-port laparoscopic cholecystectomy that is easy to perform, safe, requires no additional cost, and has high patient satisfaction

Novel laser hair removal in all skin types.

Laser has been long accepted as a solution for excess or unwanted hair growth yet traditional lasers are not always ideal for safe and effective outcome for all skin types and hair characteristics. A diode laser module combining three wavelengths (755, 810, and 1064 nm) in a single pulse was developed to provide a fast and long-term solution for subjects with various profiles. To evaluate the safety and efficacy of a Triple wavelength diode laser module for hair removal treatment in all skin types (Fitzpatrick I-VI). This was a prospective, dual centered, single-arm study. Subjects were treated with a novel diode laser module. Thirty-six subjects were enrolled, sixteen with Fitzpatrick skin types I-IV (46%) and twenty with Fitzpatrick skin types V-VI (54%). Treatment areas were axilla and bikini lines. Subjects underwent 4 treatment sessions at 6 weeks ± 5 days intervals and attended a follow-up visit 3months after the last treatment session. 2D digital photographs were taken at baseline and at the follow-up visit, and a hair count was conducted by three blinded evaluators. A significant reduction in hair count between baseline and the 3-month follow-up visit was observed in both axilla and bikini lines for all skin types. The mean hair reduction was 41.5± 19.4% and 48.1± 20.9% in the axilla and bikini line, respectively. A significant hair reduction was also observed within skin type groups; mean hair reduction 45.5± 16.9% and 40.3± 17.2% in skin types I-IV and V-VI, respectively, indicating similar efficacy for both light and dark skin types. No serious adverse events were reported. This study demonstrates that the Soprano Titanium laser platform is safe and effective for hair removal treatment in all skin types.

The Rest Is History

The Rest Is History

34361 Laser hair removal treatment considerations for Ehlers Danlos syndrome

EDS is a clinically and genetically heterogenous group of heritable connective tissue disorders involving a pathogenic disruption of collagen fibrils. Here we present a case of laser hair removal in the setting of EDS (type 6a) in a 29-year-old female phototype 2 patient successfully treated with 755-nm alexandrite laser for aesthetic laser hair removal. Our patient was born with a dislocated hip and diagnosed at age 6 with EDS type 6a with genetic confirmation of PLOD1 positive gene mutation, poor wound healing, chronic sacroiliac joint dysfunction, kyphoscoliosis and bilateral hip dysplasia. She also had a myocardial infarction, right renal artery dissection and iliac artery dissection. She was interested in aesthetic laser hair removal and noted a significant scarring history with numerous hypopigmented scars throughout her extremities with shaving leaving her with scarring on occasion. Given her complex connective tissue disease history with significant morbidity particular consideration was given to planning her laser hair removal treatment sessions for the bikini line. Clinically our patient was phototype 2 with the bikini line containing dark brown terminal hair. To clinically identify endpoints and mitigate potential complications including scarring a test spot was initially performed. The test spot was performed with the alexandrite laser 755 nm, fluence 16 J/cm2, 10-ms pulse duration, 18-mm spot size, dynamic cooling device with 4 total pulses in separate areas. No undesirable endpoints, pigmentary alteration, or scarring was observed and full treatment sessions were initiated with 755-nm 16-18 J/cm2, 10-ms pulse duration, 18-mm spot size, dynamic cooling device with excellent clinical response.

Bikini Line Approach for Cosmetic Laparoscopic Cholecystectomy

Four-port laparoscopic cholecystectomy (LC) is a standard procedure. Several alternative approaches have been described to make trocar scars invisible. This study describes and was successfully administered as a pilot for feasibility and safety of a bikini line port for better aesthetic results. In patients with symptomatic cholelithiasis undergoing LC between June 2021 and December 2021, bikini line ports were used in 67 patients. With the patient in the supine position, the first trocar (11 mm) was inserted into the abdomen through the umbilicus. The other three trocars were placed in the lower abdomen at the bikini line with the help of the camera. Standard instruments were used to perform the surgery. The mean operative time was 54.66 SD 14.1 min. No intraoperative or postoperative adverse events took place. The median follow-up for this cohort was 24 weeks. Cosmetic results were satisfactory for all patients. The use of one umbilical camera port and the other three ports in the bikini line in the lower abdomen completely hides the scars from the ports’ incision. The technique was quickly adopted by regular laparoscopic surgeons with usual instruments, much to the satisfaction of patients.

Hexagonal Skin Excision in Lipoabdominoplasty Aiming for a Smaller Scar and Efficient Waist.

Summary:Standard abdominoplasty scars may extend beyond the boundaries of the abdomen. Contemporary styles of body exposure and bathing suits demand that those incisions be hidden inside the “bikini line.” Although a smaller incision used for a mini abdominoplasty might be confined to the abdomen, larger incisions to remove massive amounts of fat and skin excess from the abdomen routinely require extensions toward the groin or iliac areas. Preoperative marking of the incision in an abdominoplasty procedure plays a key role in the shape, length, and position of the resulting scar. Undermining, traction, and resection of redundant tissue also influence these outcomes; therefore, we aim to standardize the abdominoplasty excision pattern. A uniform hexagon design for skin excision was used in 22 patients, with measures that may be used universally, for all patients with moderate skin redundancy. The design was applied successfully to decrease the ultimate scar width, and asymmetry and increase waist definition. All patients’ wounds healed uneventfully. The scar width in all patients did not cross the mid-axillary line. The scar was shorter than the standard abdominoplasty scar that may extend beyond the mid-axillary line. This hexagonal pattern of skin excision provides a quick and consistent technique for skin excision and resultant shorter scar.

Women’s Preference for Cosmesis of Incisions Used for Open Versus Robotic Lower Urinary Tract Reconstructive Surgery

OBJECTIVE: To compare the cosmetic appeal of incisions used for open (Pfannenstiel or Vertical midline) versus robotic-assisted laparoscopic lower urinary tract reconstructive surgery in women.
 STUDY DESIGN: Cross-sectional descriptive study
 PLACE AND DURATION: Outpatient Urology Clinic of Western General Hospital, Edinburgh Scotland, UK from 1st February 2019 till 28th February 2020. 
 METHODS: All patients were provided illustrations of Pfannenstiel incision (incision at “bikini line”- (A), Vertical midline laparotomy incision (incision from midline symphysis to umbilicus –( B), Robotic-assisted laparoscopic incisions-variation I- (C) and Robotic-assisted laparoscopic incisions-variation II (-D). Patients were asked to rate each incision in order of their preference. Chi square distribution was used to compare mean previous surgeries and no previous surgeries between different preferred incisional groups and ages of the patients.
 RESULTS: One hundred patients with mean age were 53.11±15.05 years with minimum 19 years and maximum 84 years and mean BMI was 28.18±7.05 kg/m2 with minimum 15.6 and maximum 55 kg/m2 calculated. Out of 100 patients (1st preference of incision), 78% preferred incision A, 3% preferred B incision and 16% & 3% patients preferred incision C and D respectively. Similarly (2nd preference of incision) 3% patients preferred incision A, 19% preferred B incision and 56% & 22% patients preferred incision C and D respectively. The mean comparison between first preferred incision with second preferred incision with respect of surgeries (previous surgeries and no previous surgeries) showed significant difference p≤0.05 (chi value=167.692, p=0.000). Relation of preferred incisions with respect to ages of the patients showed no significant difference (Pearson relation value -0.182 and p=0.069).
 CONCLUSION: Overall, open incisions were preferred over robotic incisions. Patient perception of the "visibility" of abdominal incisions and previous experience in term of surgical scars may be the distinguishing issue to explain the difference in the preferences between open versus robotic-assisted laparoscopic incisions in women.

Laparoscopic cholecystectomy by the modified bikini line approach as a simple and safe technique

The gold standard technique for laparoscopic cholecystectomy (LC) is using four ports in the upper abdomen. However, this operative approach may not provide aesthetic satisfaction for some patients because of visible incision marks. This study sought to demonstrate that these incision marks can be hidden by safely changing the port locations. For patients with symptomatic cholelithiasis undergoing LC between March 2019 and March 2020, the modified bikini line approach was used. With the patient in the supine position with open legs, the first trocar (10 mm) was inserted into the abdomen through an 11-mm incision in the umbilicus. The other three trocars were placed in the abdomen at the bikini line with the help of a camera. The standard equipment for LC was then used to perform the surgery. The modified bikini line approach to LC was used for 38 patients. Average operative time was 28.65 min, and the average hospital stay was 1.07 days. No perioperative or postoperative complications occurred. Follow-up was at 1 week, 1 month, and 6 months. Cosmetic results were satisfactory for all patients. As an alternative to the standard LC approach, the modified bikini line technique is safe and useful in patients for whom postoperative aesthetic appearance is important. The modified approach is simple to learn and use and is effective to hide the incision marks well.

The bikini incision anterior cemented total hip arthroplasty: Assessment of radiological and clinical outcomes - A mid-term review.

Introduction: There has been an increased interest in minimally invasive direct anterior approach total hip arthroplasty (THA) to provide greater patient satisfaction, improve pain relief, and reduce the duration of hospitalisation. A direct anterior approach hybrid cemented THA, utilising a bikini line incision, can be technically challenging. We aimed to undertake radiological analysis of femoral stem cementation, clinical outcomes, and component survivorship. Methods: Over a 5-year period, 215 primary elective bikini anterior THA conducted by a single surgeon were included. All procedures were performed using a cemented collarless polished stem. The operation was performed on a standard operating table. Patients undergoing posterior approach, revision procedures, and fractured neck of femurs were excluded. Post-operative radiographs were analysed for femoral cementation quality using the Barrack grading system. Harris hip scores (HHS) were determined at 6 weeks, 12 weeks, annually thereafter and the difference in HHS was noted. Results: In total, 215 anterior bikini THA (R = 101, L = 114) were performed in 199 patients (M = 89, F = 110) with a mean age of 77 and mean follow up of 2.9 years (range = 0.5–5). Radiographic analysis of femoral cementation showed 189 femoral stems (88%) were either Barrack A or B cementation grade, suggesting optimal cementation. Lucency in the cement-bone interface occurred mainly in Gruen Zone 1 (43%) and Zone 13(46.9%). At the most recent follow-up (mean 2.9 years), component survivorship was at 99.54% (stem). Significant improvement was noted in Harris hip scores at final follow-up (from 54 preoperatively to 92.7 at 2.9 years postoperatively). Conclusion: Our results suggest that a bikini incision direct anterior approach for total hip arthroplasty can be safely employed to perform cemented femoral stems on a standard operating table.

Combined laser assisted treatment for permanent hair removal for skin types I-V with Alexandrite 755 nm and ND:YAG 1064 nm lasers.

This retrospective cohort study regarding hair removal procedures considers all the data collected in three different clinical centers from 2017 to 2019. The device used to perform the treatments was composed of an Alexandrite 755 nm and an Nd:YAG 1064 nm laser, that delivered both wavelengths in a blended simultaneous emission (Thunder MT, Quanta System, Samarate, Italy). The improvement evaluated after five sessions of treatment by an external referee was: 83.0% for armpits, 82.1% for the bikini line, 82.2% for legs, 79.6% for thorax, and 81.6% for the back. The collected temporary skin reaction data reported in this study were all acceptable and transitory resolving in less than 1 week. The level of erythema and perifollicular edema were all signs of the reached treatment endpoint. First degree burns, hyper, and hypopigmentation were also reported in a few cases but these, all resolved before the follow-up visit without any permanent skin effects. No adverse effects were thus reported to have happened. This retrospective study demonstrates the efficacy of combining Alexandrite and Nd:YAG lasers in a mixed modality with simultaneous emission. This technology permitted to treat patients with skin types I-V without any reported permanent side effects and with a high pain tolerability compared to the use of Nd:YAG in single mode.

A663 Combined Bikini Line Sleeve Gastrectomy & Bikini Line Cholecystectomy

The Bikini Line Sleeve Gastrectomy (BLSG) is a novel approach where ports are placed in the umbilicus and below the bikini line. We herein describe Combined Bikini Line Sleeve Gastrectomy & Bikini Line Cholecystectomy (BLLC).

A566 Bikini Line Sleeve Gastrectomy versus Standard Laparoscopic Sleeve Gastrectomy: 3 years outcome

The Standard Laparoscopic Sleeve Gastrectomy(SLSG) involves several upper abdominal incisions. The Bikini Line Sleeve Gastrectomy(BLSG) is a novel approach where ports are placed in the umbilicus and below the bikini line. We herein aim to compare the short and medium term outcomes of BLSG versus SLSG.

Description and Initial Experience with the "LIFT" (Less Incisions but Four Trocars) Technique for Laparoscopic Cholecystectomy.

Background: Modifications to conventional laparoscopic cholecystectomy (LC) aim to reduce trauma to the abdominal wall and improve cosmetic outcomes. Although single-incision laparoscopic surgery (SILS) provides excellent cosmetic results, the procedure is technically demanding. Herein, we describe the LIFT technique ("Less Incisions but Four Trocars"), with four trocars but only one 3-mm visible incision, using conventional instruments. Methods: Retrospective study with the LIFT technique for cholecystectomy during 2017. Access to the abdomen is obtained with two trocars (11 and 5 mm) through the same intraumbilical skin incision, and two extraumbilical 3-mm trocars for a correct triangulation (one of them concealed below the bikini line). The results are compared with a series of patients operated on with LC by the same surgical team during 2016. Results: During the study period, 90 procedures were performed. Both techniques showed similar results in terms of surgical time, conversion rate, complications, and hospital length of stay. The patients operated on with the LIFT technique reported better cosmetic evaluation and less postoperative pain at 3 months compared with LC. Conclusion: The LIFT technique is a safe and feasible alternative for cholecystectomy that can provide a significant improvement from the cosmetical point of view, mostly for those patients who are especially concerned with their body image.

New Ports Placement for Robotic Cholecystectomy

Introduction: Since advantages of robotic surgery is being more emphasized, robotic cholecystectomy (RC) cases are increasing. Ajou group had introduced a method called which technique places the trocars transversally on the bikini line and it makes cosmesis and pain beneficial. However, RC with low incision port has several limitations. Therefore, we changed port placement which may be a one of safe tehniques for RC. Method: This study retrospectively reviewed data for patients who received RC with port changing method (RCPC, n = 33) and RC with low incision port (RCLI, n = 81) from February 2016 to February 2017 and surgical variables were analyzed. Results: Patients in both groups had similar demographic features and indications for surgery. The RCPC group required no conversions to conventional robotic surgery and no additional operation, whereas the RCLI group had one incisional hernia (1.2%) and two bowel perforation (2.4%) cases. Length of stay (4.29 ± 0.72 vs. 5.13 ± 0.93 days, respectively; p = 0.123) did not significantly differ between the RCPC and SCLI groups. However, the RCPC group had shorter operative time (71.30 ± 48.88 vs. 74.70 ± 30.16 minutes; p = 0.772) than the RCLI group, although the parameters mentioned above were not statistically significant. Conclusion: Robotic cholecystectomy with bikini line incision has some limitations even though it has cosmetic benefits. Whereas robotic surgery with changing port method is one of safe and feasible procedures for performing robotic cholecystectomy. Also nothing more to say that it gains cosmesis effect and escapes complications.

The Anterior Subcutaneous Pelvic Fixator (INFIX) in an Anterior Posterior Compression Type 3 Pelvic Fracture

The purpose of this video is to describe the equipment, anatomy, and surgical technique of anterior subcutaneous pelvic fixation (INFIX) using pedicle screws and a rod in an Anterior Posterior Compression 3 pelvic fracture, as well as how to distract in lateral compression fractures. The equipment required includes standard spine pedicle screw sets with long screws, 70-110 mm in length, and 7 or 8 mm in diameter. The approach is a mini open and one needs to be familiar with the iliac oblique, obturator outlet, and obturator inlet views. The length of the screw is measured from the sciatic notch to the skin, and they are placed so that the head sits just below the skin. The rod is passed just under the skin along the bikini line and the construct compressed or distracted against a c-clamp while monitored with fluoroscopy. In Orthopaedic Trauma Association C type injuries, we leave c-clamps on the outside the screws to reinforce them or use monoaxial screws. The implants are removed at 3-6 months postop. The patients tolerate the implants and are able to sit and stand with out difficulty. Complications include lateral femoral cutaneous nerve irritation, heterotopic bone, loss of fixation if the implants are applied incorrectly. The INFIX procedure for anterior pelvic fixation is based on standard techniques that are familiar to the Orthopaedic Pelvic Surgeon including supraacetabular screws. Rod bending, rod passing, determining the ideal height of the screws, and distraction/compression maneuvers are demonstrated in this video.