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Ambulatory bariatric surgery: a prospective single-center experience.

Abdulaziz Karam Ali1, Ali Safar1, Phil Vourtzoumis1

  • 1Centre for Bariatric Surgery, Department of Surgery, McGill University, Montreal, Canada.

Surgical Endoscopy
|July 15, 2024
PubMed
Summary

Same-day discharge (SDD) bariatric surgery, including sleeve gastrectomy (SG) and gastric bypass (RYGB), shows a high success rate and low morbidity. This approach is increasingly adopted, improving access for patients with severe obesity.

Keywords:
Ambulatory bariatric surgeryDay surgeryERASGastric bypassSame-day surgerySleeve gastrectomy

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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.