Surgical outcomes of laparoscopic sleeve gastrectomy by single surgeon: Before and after learning curve in a non-tertiary low volume bariatric center.

Abstract

In Korea, the need for bariatric surgery (BS) is increasing because of the increasing incidence of morbid obesity. There is no special training program for BS, and most BS are conducted in non-tertiary hospitals in capital area. We evaluated the surgical outcomes of laparoscopic sleeve gastrectomy (LSG) before and after the learning curve (LC) to prove that the barrier of entry for LSG is not very high. We retrospectively analyzed the data of patients who underwent LSG in a secondary hospital without the supervision of an experienced surgeon between April 2019 and August 2022. We compared the surgical outcomes and changes in body measurements before the LC (BL) and after the LC (AL) after 1 year of follow-up. The duration of operation for BL and AL were 118.4 and 61.9min (p=0.000), respectively. No mortality was observed. There were four and eight cases of morbidity; the weight loss after 1 year was 90.6 and 89.7kg (p=0.804); changes in body mass index (BMI) were 10.3 and 10.2kg/m2 (p=0.928); excess weight loss after 1 year was 93.0 and 89.3% (p=0.762); and excess BMI loss after 1 year was 92.7 and 89.5% (p=0.807) in the BL and AL groups, respectively. %Total weight loss was 26.8 and 23.7 in the BL and AL group. There was no statistical significance of all parameters of body measurements between two groups. LSG can be safely and effectively performed by novice bariatric surgeons in non-tertiary hospitals if patients are cautiously selected. Surgical outcomes of BL and AL is not different, except for the operation time.