Introduction: Among the existing weight-loss procedures, laparoscopic sleeve gastrectomy has gained increasing popularity in the past decade, due to its remarkable results concerning EWL and resolution of comorbidities. However, most of major concerns for a team initiating with sleeve gastrectomy, still remain as subjects of major controversy among authors. Aim: to present a single surgeon's technique and initial results with laparoscopic sleeve gastrectomy and review the latest literature for main concerns of a novice team. Material: Six patients aged 24-49years, underwent full preoperative workup, including history, physical examination, evaluation from cardiologist, anesthesiologist, as well as clinical dietician and pneumologist. A laparoscopic sleeve gastrectomy was offered as the most suitable bariatric procedure for 5 of the patients. One of the patients underwent a robotic-assisted technique. Results: All 6 patients followed an uncomplicated course. All patients were assessed for leaks on postoperative day 2 by gastrographin swallow. One patient presented with high fever on postoperative day 4 and was readmitted. No leaks were noted in any of the patients. Conclusion: Reinforcing the staple line during sleeve gastrectomy by suturing and glue is the routine followed by the authors. Robotics seem to facilitate sleeve gastrectomy, especially during challenging mobilization of the fundus near the spleen as well as during intracorporeal suturing. Advances in Obesity Weight Management & Control Research Article Open Access Concerns during initiation of sleeve gastrectomy in a laparoscopic bariatric program: a single surgeon's initial experience and review of latest literature 18 Copyright: ©2018 Hirides et al.