Short-Term Safety and Complication Profile of Outpatient SADI-S: A Comprehensive Multicenter Analysis

Area of Science:

• Bariatric surgery
• Minimally invasive surgery
• Obesity treatment

Background:

• Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is an effective weight-loss procedure.
• Established inpatient safety profiles exist for SADI-S.
• Outpatient safety and same-day discharge for SADI-S remain largely unstudied.

Purpose of the Study:

• To evaluate the short-term safety of primary SADI-S procedures performed in outpatient settings.
• To assess the complication profile of outpatient SADI-S across multiple surgical centers.
• To determine the feasibility of same-day discharge after SADI-S.

Main Methods:

• Retrospective analysis of a prospectively maintained database.
• Inclusion of 327 outpatient primary SADI-S procedures from May 2020 to January 2023.
• Procedures performed by six surgeons across three U.S. centers without standardized techniques.

Main Results:

• Mean patient BMI was 45.2 kg/m²; common comorbidities included sleep apnea, hypertension, and type 2 diabetes.
• Low 30-day complication rates: 3.6% overall, 1.8% reintervention, 0.9% readmission, and 0.9% reoperation.
• Average length of stay was approximately 5 hours, with minimal intraoperative complications (0.3%).

Conclusions:

• Outpatient SADI-S is associated with favorable short-term safety in carefully selected patients.
• Low rates of complications, reinterventions, and readmissions support its feasibility.
• Further prospective validation is recommended for specialized centers performing outpatient SADI-S.