Additional concerns exist regarding patient safety if it is not a

Additional concerns exist regarding patient safety if it is not a programmed surgery, thus rendering SILC/LESS cholecystectomy unavailable to a large subset of patients. Initial selleck chemicals Dovitinib data showing increased complication rate along with a longer operating time, lack of standardization, and instrumentation makes SILC/LESS cholecystectomy still an experimental procedure that requires further development in order to be applicable to general surgeons worldwide. Authors’ Contribution All the authors contributed equally. Conflict of Interests The authors have no conflicting interests.
Obesity has reached epidemic levels in many countries around the world [1]. The prevalence of obesity has steadily increased over the years irrespective of demographic factors such as age, sex, race, ethnicity, or educational level [2].

It is also increasing rapidly in both industrialized and developing countries [3]. Worldwide, nearly 250 million people are obese, and the WHO has estimated that in 2025, 300 million people will be obese [4]. It is a well-known fact that obesity is associated with increased morbidity and mortality. There have been many published reports from several Caribbean nations such as Jamaica, Barbados, Trinidad & Tobago, and St. Lucia concerning the steady rise in the prevalence of obesity from primary school age through adolescence and adulthood [5�C8]. A recent PAHO/WHO report suggests that more than half of the population in Trinidad & Tobago fall within the parameters of being either overweight or obese, which is indeed quite alarming [9].

The medical management of obesity has a poor track record, but bariatric surgery has demonstrated superior weight loss and dramatic improvement in comorbidities in the postoperative period. In the developed world, bariatric surgery is usually performed at designated centers of excellence on the basis that this leads to better outcomes. However, it is debatable if bariatric surgery should be limited to such high-volume centers [10]. In addition to control of obesity, bariatric surgery is also very effective in the management of diabetes mellitus and hypertension, which commonly afflicts this population. Since the prevalence of diabetes mellitus and hypertension is also very high in the Caribbean nations, it may well be argued that bariatric surgery should be commonly available commonplace in these islands regardless of the patient turnover once results are acceptable.

With this background, this paper aims to investigate and report the safety and effectiveness of bariatric surgery in a low-volume center in a third world setting. 2. Methods After necessary approval from Hospital Anacetrapib Authorities, data regarding patients who underwent bariatric surgery in a single surgical unit (which offers the bariatric surgery service in the whole island of Trinidad & Tobago) were prospectively recorded for a period of eight years (July 2003 through June 2011) and analyzed retrospectively.

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