title: Initial experience with laparoscopic sleeve gastrectomy by a novice bariatric team in an established bariatric center--a review of literature and initial results.
abstract: BACKGROUND
  Laparoscopic sleeve gastrectomy (LSG) is a highly successful approach to morbid obesity with low incidence of complications. The literature suggests a learning curve of 50-100 cases for attaining proficiency and reducing the complication rates for laparoscopic bariatric surgery. The aims of this paper were to review the literature of initial cases by bariatric surgeons worldwide and to report the experience of initial 50 cases of LSG by a novice bariatric team in a single center. The objective was to evaluate the outcomes for laparoscopic bariatric surgery in the first 50 patients by a novice team of bariatric surgeons in an already established bariatric surgery program with short-term follow-up.
  
  
  METHODS
  All surgeries were done by a new bariatric team who underwent laparoscopic fellowship training under a bariatric team with an experience of over 600 bariatric procedures. Fifty consecutive patients from March 2010 to January 2012 were offered LSG and followed up for a minimum of 6 months. Weight loss and comorbidity resolution were tabulated and assessed.
  
  
  RESULTS
  Mean preoperative and postoperative BMIs were 46.6 and 35.7 kg/m2, respectively. There were no life threatening postoperative complications or mortality. The median percent excess weight loss was 50.3% at the end of 6 months. Comorbidity resolution values were 96% for obstructive sleep apnea, 89% for diabetes mellitus, and 87% for joint pains, among the most common comorbidities.
  
  
  CONCLUSIONS
  LSG is effective in achieving weight loss and in improving comorbidities with minimal complications even at the hands of novice bariatric surgeons with good laparoscopic skills and adequate bariatric training.
authors.affiliation: Department of General Surgery, Sir Ganga Ram Hospital, New Delhi, 110060, India.ashishdey_78@rediffmail.com
authors.forename: Ashish
authors.initials: A
authors.lastname: Dey
authors.forename: Tarun
authors.initials: T
authors.lastname: Mittal
authors.forename: Vinod K
authors.initials: VK
authors.lastname: Malik
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000517:prevention & control; D004503:Education, Medical, Graduate; D005257:Fellowships and Scholarships; D005260:Female; D015391:Gastroplasty / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000517:prevention & control; D007037:Hypothyroidism / Q000453:epidemiology / Q000517:prevention & control; D010535:Laparoscopy; D059032:Learning Curve; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000503:physiopathology / Q000601:surgery*; D012074:Remission Induction; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology / Q000517:prevention & control; D016896:Treatment Outcome; D015431:Weight Loss