Bariatric procedures as day/short stay surgery: is it possible and reasonable?

There is an increasing tendency to extend the repertoire of procedures suitable for ambulatory care. The purpose of this review is to present recent information on progress in bariatric surgery and anaesthesia for morbidly obese patients, specifically looking for clinical reports on the success and/or problems related to an ambulatory or short-stay setting.

Recently, many reports of successful short-stay bariatric surgery have been published, highlighting the importance of proper patient selection and preparation. Further, a dedicated anaesthetic regimen together with experienced surgeons in high-volume centres seem to be the criteria for success. Very few clinical reports exist for a true ambulatory setting, and are only for gastric banding. Adequate back-up routines, concomitant disease, and optimal patient satisfaction may still be a challenge when these procedures are done in an ambulatory setting.

Despite proper safety and feasibility, it may still be a question of patient quality and acceptance for increasing the number of bariatric procedures performed as true ambulatory care. There is definitely potential for doing most of these procedures on a short-stay basis, however, allowing for a low threshold for individual management of those patients who require more extensive care.