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. 2023 Jul;37(7):5553-5560.
doi: 10.1007/s00464-022-09721-w. Epub 2022 Oct 21.

Ambulatory sleeve gastrectomy: a prospective feasibility and comparative study of early postoperative morbidity

Safiya Al-Masrouri  1   2 , Abdulaziz Alnumay  1   2 , Phil Vourtzoumis  1   2 , Olivier Court  1   2 , Sebastian Demyttenaere  1   2 , Liane S Feldman  3   2 , Amin Andalib  4   5
Affiliations

Ambulatory sleeve gastrectomy: a prospective feasibility and comparative study of early postoperative morbidity

Safiya Al-Masrouri et al. Surg Endosc. 2023 Jul.

Abstract

Background: Given its short procedure time and low morbidity, there is enthusiasm to perform sleeve gastrectomy (SG) in an outpatient setting. However, most relevant studies include an overnight stay at a medical facility (≤ 24-h). Hence, we investigated the feasibility and safety of a same-day discharge (SDD) protocol for laparoscopic SG.

Methods: In a prospective pilot study (02/01/2021-02/28/2022), all patients planned for SG were screened for eligibility. Patients met the inclusion criteria if they were ≤ 65 years old, without major comorbidity, and lived close to the hospital. Postoperatively, patients who met discharge criteria were sent home directly from the recovery room. Patients were called the same night and the next morning. Feasibility was defined as discharge on the day of surgery without emergency department (ED) visit or readmission within 24-h. Secondary outcomes, including 90-day morbidity, were compared to patients who met inclusion criteria but chose a same-day admission (SDA) approach during the same study period. Descriptive statistics are displayed as count (percentage) and median (interquartile range).

Results: A total of 320 patients were planned for SG during the study period, 229 of whom met eligibility criteria and underwent SG with 56 agreeing to SDD-SG while 173 opted for SDA-SG. Baseline characteristics were all similar between both groups except for obstructive sleep apnea being more prevalent in SDA-SG group (38.2% vs. 16.1%; P < 0.001). Operative characteristics including procedure time were similar between both groups. Successful SDD-SG was achieved in 54(96%) of patients with a median of 6.0(1.0) hours of stay in the recovery room. Ninety-day morbidity was similar between SDD-SG and SDA-SG groups (1.8% vs. 6.9%, respectively; P = 0.196).

Conclusion: A SDD protocol for laparoscopic SG was feasible and safe in selected patients. Larger studies that evaluate patient reported outcomes and include bypass-type procedures may be needed to guide safe use of ambulatory bariatric surgery.

Keywords: Ambulatory bariatric surgery; Bariatric surgery; Day surgery; Same-day discharge; Sleeve gastrectomy.

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Conflict of interest statement

Dr. Liane S. Feldman receives speaker fees and is recipient of an unrelated investigator-initiated research grant from Theator. Drs. Safiya Al-Masrouri, Abdulaziz Alnumay, Phil Vourtzoumis, Olivier Court, Sebastian Demyttenaere, and Amin Andalib have no conflicts of interest or financial ties to disclose.

Figures

Fig. 1
Fig. 1
Study flowchart
See this image and copyright information in PMC

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