There is no more technically demanding laparoscopic procedure than laparoscopic proximal gastric bypass. Furthermore, training and skill in advanced laparoscopy are inadequate background for developing a program since the bariatric patient presents many complex issues in management for the surgeon. Thus, the novice must master the skills of two disciplines: advanced laparoscopy and bariatric surgical care. The authors bring forward their significant experience in bariatric surgery and lessons learned from the development of their laparoscopic obesity surgery program in order to provide a resource to surgeons committed to bringing safe and effective laparoscopic treatment to their morbidly obese patients.