Ambulatory bariatric surgery: a prospective single-center experience

Area of Science:

• Bariatric Surgery
• Minimally Invasive Procedures
• Patient Outcomes

Background:

• Ambulatory bariatric surgery is gaining traction to enhance access for individuals with severe obesity.
• This study builds upon prior research, examining ambulatory bariatric surgery trends over three years, focusing on success and failure predictors.

Purpose of the Study:

• To assess the safety and efficacy of a same-day discharge (SDD) protocol for bariatric surgery.
• To identify predictors of success and failure in ambulatory sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB).
• To analyze trends in the adoption of SDD bariatric procedures over time.

Main Methods:

• Prospective, single-center follow-up study of patients undergoing planned SDD SG or RYGB (March 2021-February 2024).
• Assessment of trends in SDD surgeries across six 6-month intervals.
• Primary endpoint: successful discharge on surgery day without ED visit or 24-hour readmission; Secondary endpoint: 30-day postoperative morbidity.

Main Results:

• 811 SG and 325 RYGB procedures were performed; 30% of SGs and 6% of RYGBs were SDD.
• SDD success rates were high: 89% for SG and 90% for RYGB.
• The 30-day readmission rate for the SDD cohort was 1.5%, with nausea/vomiting being the primary reason for failed SDD after SG.

Conclusions:

• The SDD protocol for bariatric surgery demonstrates a favorable safety profile with high success rates.
• Low postoperative morbidity supports the continued increase in ambulatory bariatric procedures, particularly SG.
• SDD bariatric surgery offers a viable option for improving access and outcomes in patients with severe obesity.