Safety of Same-Day Discharge Bariatric Surgery: A Comprehensive Analysis of 457 Cases Across Multiple Procedure Types

Outpatient bariatric surgery offers reduced hospital stays and healthcare costs, with promising safety outcomes. This study analyzes the short-term results of stand-alone primary and revision bariatric surgeries, alongside concomitant foregut and abdominal surgeries associated with bariatric procedures, to assess their safety and efficacy in an outpatient setting at a free-standing ambulatory center.

A retrospective study was conducted on 457 same-day discharge (SDD) bariatric cases performed by a single surgeon at a free-standing ambulatory center between January 2021 and July 2024. The procedures included sleeve gastrectomy (SG), duodenal switch (DS), adjustable gastric band (AGB) removal, and Roux-en-Y gastric bypass (RYGB). Concomitant foregut and abdominal surgeries associated with bariatric procedures, such as hiatal hernia repair (HHR), cholecystectomy, fundoplication, and ventral hernia repair, were performed when clinically indicated.

Of the 457 cases, 97.8% were primary surgeries, and 2.1% were revisions. Stand-alone procedures accounted for 39.3%, and 60.6% were concomitant. SG constituted 74.8% of cases, followed by HHR (16.1%), DS (5.4%), AGB removal (2.6%), and RYGB (.8%). The mean operative time was 79.9 ± 24.3 min, with a mean length of stay of 3 h 52 min (± 1:10). The 30-day complication rate was 2.1%, with Clavien-Dindo grade IIIb complications in .8% of patients. Patient satisfaction was high, with a mean score of 9.8.

Outpatient bariatric surgeries demonstrated strong safety with minimal complications, underscoring their viability in carefully selected patients. Staged approaches for complex cases further optimized outcomes, making outpatient settings a robust option for a wide range of bariatric procedures.