Original articleDoes the future of laparoscopic sleeve gastrectomy lie in the outpatient surgery center? A retrospective study of the safety of 3162 outpatient sleeve gastrectomies
Section snippets
Methods
In this multi-institutional retrospective study, the medical records of 3162 patients who had undergone primary LSG procedure by 21 surgeons from January 2010 through February 2018 at 9 independent outpatient surgery centers were reviewed from each institution's prospectively collected database. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki
Results
Three thousand one hundred sixty-two patients were identified. The study involved patients with a mean age of 43.1 ± 10.8 years and had 1524 (48.1%) to 1638 (51.8%) male to female ratio. The mean preoperative BMI and weight were 42.1 ± 7.1 kg/m2 and 263.5 ± 53 lbs, respectively. Of the 3162 patients, preoperative co-morbidity data were available for 2057 patients. Of the 2057 patients, 14.4%, 13.5%, 24.7%, 30.4%, and 17.6% of patients had preexisting sleep apnea, type 2 diabetes,
Discussion
This is the first multi-institutional study on primary LSG at outpatient surgical centers. Additionally, this is the largest cohort studied on primary LSG at an outpatient surgery center. The results are consistent with conclusions from other studies that outpatient LSG can be safely performed with a low complication rate. Our readmission, reoperation, and reintervention rates after outpatient SG were similar to those of the same procedures performed during hospital admission [14], [15], [16].
Conclusions
LSG for select patients can be performed safely on an outpatient basis. The exact reasons for early discharge and low readmission rates have yet to be elucidated.
Disclosure
D.C., the corresponding author, reports personal fees and other from Medtronic outside the submitted work. All other authors have no conflicts of interest to declare.
Reference (32)
- et al.
Outpatient laparoscopic sleeve gastrectomy in a free-standing ambulatory surgery center: first 250 cases
Surg Obes Relat Dis
(2014) - et al.
Laparoscopic sleeve gastrectomy as a viable option for an ambulatory surgical procedure: our 52-month experience
Surg Obes Relat Dis
(2018) - et al.
30-day readmissions after sleeve gastrectomy versus Roux-en-Y gastric bypass
Surg Obes Relat Dis
(2016) - et al.
Outpatient laparoscopic sleeve gastrectomy: first 100 cases
J Clin Anesth
(2016) - et al.
Thirty-day readmission after laparoscopic sleeve gastrectomy—a predictable event?
J Gastrointest Surg
(2016) - et al.
Four-year experience with outpatient laparoscopic adjustable gastric banding
Surg Obes Relat Dis
(2013) - et al.
High acuity sleeve gastrectomy patients in a free-standing ambulatory surgical center
Surg Obes Relat Dis
(2017) - et al.
Fast track bariatric surgery: safety of discharge on the first postoperative day after bariatric surgery
Surg Obes Relat Dis
(2017) - et al.
Cost of bariatric surgery and factors associated with increased cost: an analysis of national inpatient sample
Surg Obes Relat Dis
(2017) Minimally invasive and robotic surgery
JAMA
(2001)
Laparoscopic laser cholecystectomy: a comparison with minilap cholecystectomy
Surg Endosc
Returns to specialization: evidence from the outpatient surgery market
J Health Econ
Enhanced recovery after bariatric surgery: systematic review and meta-analysis
Obes Surg
Outpatient weight loss surgery: initiating a gastric bypass and gastric banding ambulatory weight loss surgery center
JSLS
Cited by (33)
Comment on: Making lemonade with lemons: a multicenter effort to improve outpatient sleeve gastrectomy amid the COVID-19 pandemic
2023, Surgery for Obesity and Related DiseasesMaking lemonade with lemons: a multicenter effort to improve outpatient sleeve gastrectomy amid the COVID-19 pandemic
2023, Surgery for Obesity and Related DiseasesOutcomes of same-day discharge sleeve gastrectomy and Roux-en-Y gastric bypass: a systematic review and meta-analysis
2023, Surgery for Obesity and Related DiseasesCitation Excerpt :This was considerably higher than the rest of the studies, which ranged from .6% to 8.5%. Reasons for readmission after SDD SG were reported in 9 of 10 studies [14–17,19,23–25,27]. Nausea and vomiting constituted 23.5%–65% of the reasons for readmission in 5 of the studies [14,15,19,23,27], while it was not a cause for readmission in the remaining 4.
Laparoscopic hiatal hernia repair as same day surgery: Feasibility, short-term outcomes and costs
2020, American Journal of SurgeryDoes ERAS impact outcomes of laparoscopic sleeve gastrectomy in adolescents?
2020, Surgery for Obesity and Related DiseasesProspective Evaluation of a Standardized Opioid Reduction Protocol after Anorectal Surgery
2020, Journal of Surgical Research