Surgeon perspectives on same-day discharge after bariatric surgery: a statewide survey in Michigan

Although the prevalence of same-day discharge (SDD) after bariatric surgery has more than doubled in recent years, the practice remains controversial. We conducted a survey of practicing bariatric surgeons across Michigan to evaluate surgeon perspectives toward SDD.

To characterize surgeon perceptions and barriers to SDD adoption in Michigan.

Academic and community bariatric surgery programs participating in the Michigan Bariatric Surgery Collaborative (MBSC), a statewide quality improvement collaborative.

Surgeon survey was distributed to all surgeons of MBSC. This survey included questions regarding current practice of SDD and potential concerns or barriers to implementation. The questions were multiple-choice items with optional free-text responses, with some allowing selection of more than one response option.

The overall response rate to the survey was 100% (N = 76). Only 15 (20%) reported performing SDD. Concerns about "Overall risks" (39 [51%]) and "Fear of complications" (26 [34%]) were identified as the leading reasons for not performing. Key institutional barriers included "Safety concerns" (41 [54%]) and "Lack of outpatient resources" (22 [29%]). Perceived advantages were rarely endorsed, and no free-text responses supported SDD. The most frequently cited disadvantages were "Failure to rescue" (69 [91%]) and "Inability to monitor" (64 [84%]).

SDD after bariatric surgery is not widely adopted in Michigan, primarily due to surgeon safety concerns and limited outpatient resources. These findings indicate that institutional readiness and postoperative support capacity remain key constraints to broader SDD adoption.