4% . Despite being a low-volume center (218 bariatric cases over 8 years) and a low-volume surgeon (27 cases per year) and not fitting the criteria for a center of excellence, we have demonstrated that bariatric surgery can be performed safely with acceptable morbidity better and mortality. This is made possible by having a well-trained vigilant surgical team, thorough preoperative evaluation by a multidisciplinary team and close personalized postoperative followup by the surgeon himself for all cases. 5. Conclusion Obesity is highly prevalent in the Caribbean and bariatric surgery is a safe and effective therapy for this modern epidemic. Bariatric surgery provides effective weight loss, dramatic resolution for many obesity-related diseases.
This study demonstrated that bariatric surgery is safe and effective in this low-volume center in a third world setting. ��Patient numbers�� should not be exclusively considered as a factor to determine and/or predict safety of bariatric surgery in surgical practice. Furthermore, patients should not be deprived access to this most important treatment exclusively based on number of procedures but rather on outcome.
The primary search found 155 potentially relevant studies. After eliminating studies in which the access route to the abdomen was not per SPLS or the organ studied was not small or large bowel, 108 studies remained. Of these, 34 studies reported on SPLS in patients with IBD (Figure 1). These 34 studies met the inclusion criteria and were analyzed in detail. The selected studies were comprised of 5 case reports, 19 case series, and 10 case-controlled studies.
There were no prospectively randomized studies available. Figure 1 Single-Port Laparoscopic Surgery for inflammatory bowel disease: selection of analyzed studies. The 34 selected studies reported on 1023 SPLS patients in total, including 301 patients with IBD. Among these, there were 150 patients with Crohn’s disease and 151 patients with ulcerative colitis. 8 studies described data of 10 or more IBD patients. However, since 5 groups of surgeons contributed more than one (2�C4) publication to the final selection, quite a number of individuals might have been repeatedly reported, substantially reducing the actual number of reported IBD patients treated by SPLS technique. In contrast, 19 studies originated from researchers with only one publication on SPLS including IBD patients.
14 studies were restricted to SPLS in IBD patients only, whereas the other 20 studies included IBD patients in a mixed cohort of SPLS colorectal surgery. Among the 14 IBD-only studies, there were 5 case reports, 6 case series including more than one IBD patient, and 3 case-controlled studies. The selected studies were published in the years 2010 (n = 8) and Brefeldin_A 2011 (n = 21), and 2012 (n = 5), including those studies that were published online ahead of print. 3.2.