Same-day discharge on laparoscopic Roux-en-Y gastric bypass patients: an outcomes review

Abstract

Introduction: The objective of this research was to study safety and outcomes in patients who underwent laparoscopic Roux-en-Y gastric bypass (LRYGB) on an ambulatory outpatient basis. As the prevalence of morbid obesity increases, more patients are opting for surgical weight loss as a means to combat their chronic disease. There are several studies demonstrating the safety and feasibility of select patients undergoing LRYGB on a 23-h outpatient basis, but few studies exist regarding the safety and efficacy of these procedures being performed on an ambulatory outpatient basis.

Methods: A retrospective review was completed on all patients who underwent a laparoscopic gastric bypass procedure from 2008 to 2018 at a single outpatient ambulatory surgery center. Median BMI was 46.7 kg/m². Inclusion criteria included age > 18 and < 65, ASA class less than 3, completion of a bariatric surgery preparation program, no history of major cardiovascular events, and no prior major open abdominal operations. Exclusion criteria included males > 55 years, BMI > 55 for men, and BMI > 60 for women. Operations included primary LRYGB procedures. We determined 30-day post-operative morbidity and mortality for all patients.

Results: There were 398 patients who underwent a LRYGB on an ambulatory basis. After thorough chart review, a total of 362 patients were included. The majority were women (315, 87%). The median age was 42 (range 19-65). Seven (1.93%) patients were directly admitted to the hospital, while 13 (3.59%) patients were admitted to the hospital after initial discharge. There were 3 (0.83%) leaks, 4 (1.11%) bleeds requiring transfusion, no wound infections, 1 (0.28%) obstruction, one (0.28%) venous thrombotic event and/or pulmonary embolism, and 9 (2.49%) reoperations. There were zero deaths.

Conclusions: This study demonstrates that laparoscopic Roux-en-Y gastric bypass is both feasible and safe when performed on select patients on an ambulatory outpatient basis.

Keywords: Gastric bypass; Outpatient surgery; Same-day discharge.