title: Learning curve for laparoscopic sleeve gastrectomy: role of training in a high-volume bariatric center.
abstract: Since the great diffusion of laparoscopic treatment of obesity, there is a growing interest concerning the learning process for those surgeons who undertake the bariatric activity. However, papers analyzing the learning curve (LC) for sleeve gastrectomy (SG) are still scarce. This study aims to investigate whether the LC for SG of a novice bariatric surgeon might be positively influenced by the training in a high-volume bariatric center (HVBC).
  
  
  
  Between October 2010 and January 2014, 128 patients underwent SG by the same young surgeon who previously attended a 2-year training in a HVBC. His LC has been divided into three consecutive periods: in the first period (1st-47th SGs) he operated in the HVBC, while in the second (48th-88th SGs) and third period (89th-128th SGs) he moved to a novel department where surgical and ancillary staff were initially not confident with bariatric procedures but progressively owned the proper experience. Preoperative characteristics, operative data, complications and postoperative results of the three periods were compared.
  
  
  
  Mean follow-up was 1 year. Preoperative patients' characteristics were homogeneous. No significant differences have been registered among the three periods concerning operative data, mortality, intra- and post-operative complications, weight loss outcomes and comorbidities' resolution. Post-operative follow-up rates at 6 and 12 months were 98.4 and 92.1 %, respectively.
  
  
  
  Long-lasting fellowship in a HVBC might allow the novel bariatric surgeon to safely and proficiently overcome the LC for SG, even in a new established bariatric setting.
authors.affiliation: Department of Surgical Sciences, Policlinico Umberto I, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Casella
authors.affiliation: Department of Surgical Sciences, Policlinico Umberto I, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy. lelesori@hotmail.com.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Soricelli
authors.affiliation: Department of Surgical Sciences, Policlinico Umberto I, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Giannotti
authors.affiliation: Department of Radiology, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Maria Giulia
authors.initials: MG
authors.lastname: Bernieri
authors.affiliation: Department of Surgical Sciences, Policlinico Umberto I, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Genco
authors.affiliation: Department of Surgical Sciences, Policlinico Umberto I, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Basso
authors.affiliation: Department of Surgical Sciences, Policlinico Umberto I, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
authors.forename: Adriano
authors.initials: A
authors.lastname: Redler
mesh_terms: D000328:Adult; D005260:Female; D005743:Gastrectomy / Q000193:education* / Q000379:methods; D006801:Humans; D007558:Italy; D010535:Laparoscopy / Q000193:education* / Q000379:methods; D059032:Learning Curve; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult
keywords: Learning curve; Sleeve gastrectomy; Surgical training