Does the future of laparoscopic sleeve gastrectomy lie in the outpatient surgery center? A retrospective study of the safety of 3162 outpatient sleeve gastrectomies

Surve, Amit; Cottam, Daniel; Zaveri, Hinali; Cottam, Austin; Belnap, Legrand; Richards, Christina; Medlin, Walter; Duncan, Titus D.; Tuggle, Karleena; Zorak, Alberto; Umbach, Thomas; Apel, Matthew; Billing, Peter; Billing, Josiah; Landerholm, Robert; Stewart, Kurt; Kaufman, Jedediah; Harris, Eric; Williams, Michael L.; Hart, Christopher; Johnson, W. R.; Lee, Christy; Lee, Ciara; DeBarros, John; Orris, Michael; Schniederjan, Bleu; Neichoy, Bo; Dhorepatil, Aneesh; Cottam, Samuel; Horsley, Benjamin

doi:10.1016/j.soard.2018.05.027

Cited by 37 publications

(25 citation statements)

References 29 publications

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“…The readmission rates after SG being performed as same-day surgery are found to be between 0.6% and 8.5%, and the reoperation rates are 0.6% to 3% [4,[6][7][8][11][12][13]. In the present study, the readmission rate was 6.5% and the one re-operation was due to gastric leak.…”

Section: Discussionmentioning

confidence: 47%

“…Cholecystectomy, inguinal hernia repair, fundoplication surgery are some of the surgeries which are done as same-day surgery with good results, both worldwide and at our department [19,20]. Bariatric surgery has also been performed in same-day settings, but with careful patient selection, accepting only patients with minimal surgical risk [6,7,11,13].…”

Section: Discussionmentioning

confidence: 99%

“…Most of the evidence available on SG as same-day surgery is based on retrospective reviews [11][12][13]. The aim of our study was to demonstrate the feasibility of SG as a same-day surgery and to determine factors influencing the duration of hospital stay, such as type of anesthesia, time of procedure, degree of post-operative nausea and vomiting (PONV) and pain, American Society of Anesthesiologists (ASA) score or previous abdominal surgery affects the hospital stay.…”

Section: Introductionmentioning

confidence: 99%

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Gastric sleeve resection as day-case surgery: what affects the discharge time?

Aftab

Fagerland

Gondal

et al. 2019

Surgery for Obesity and Related Diseases

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Background: Sleeve gastrectomy (SG), with its short operating time, is possible to perform as same-day surgery, with the most common reason for requiring overnight hospital stay being post-operative nausea and vomiting. Objective: To demonstrate the feasibility and safety of SG as same-day surgery with regards to complication rate. Additionally, the study aimed to evaluate factors determining the duration of hospital stay, such as type of anesthesia, time of procedure, degree of postoperative nausea and pain, American Society of Anesthesiologists (ASA) score or previous abdominal surgery. Setting: Non-academic primary referral center. Method: A sub-study of a single-center, double blind, randomized controlled trial. Patients included in this study underwent SG and were randomized into one of the two types of anesthesia; Total intravenous anesthesia (TIVA) with propofol, or desflurane. Primary endpoint was the number of patients discharged the same day as surgery. Secondary endpoints were unplanned telephone calls, readmission rate and complication rate. Time of procedure was registered by the staff at the operation theatre. Visual analogue scales (VAS) score estimating patients' intensity of pain and nausea were completed at the postoperative (PO) unit, surgical ward, and 24-48 hours post-operatively. Results: Ninety-three patients were included in the study. Fifty-nine (63%) were discharged the same day as surgery (32 desflurane and 27 TIVA), 30 patients (32%) were discharged one 2 day following surgery, and four patients (4%) were discharged after more than two days (15 desflurane and 19 TIVA). The most common reasons for prolonged stay were pain, nausea and fatigue. Statistical analyses showed no association between day of discharge and the type of anesthesia, time of the procedure, degree of postoperative nausea and vomiting (PONV), pain intensity, ASA score, or previous abdominal surgery. Conclusion: Same-day surgery is feasible and safe in terms of low complication rate. The type of anesthesia, time of procedure, degree of PONV and pain, ASA score and previous abdominal surgery does not appear to affect length of hospital stay.

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Section: Discussionmentioning

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Gastric sleeve resection as day-case surgery: what affects the discharge time?

Aftab

Fagerland

Gondal

et al. 2019

Surgery for Obesity and Related Diseases

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“…Introduction of fast-track surgery and recent developments in the perioperative management has resulted in improved outcomes of patients undergoing bariatric surgery and decreased the length of hospital stay [1][2][3]. Shortening of hospital stay to 1 night has not affected the short-term safety of patients undergoing laparoscopic Roux-en-Y gastric bypass (RYGB) [4,5]. In many bariatric centers, standard care for patients undergoing a RYGB is 1 overnight stay.…”

Section: Introductionmentioning

confidence: 99%

“…Few studies have described same-day discharge in patients undergoing bariatric surgery, with same-day discharge defined as surgery without postoperative overnight hospital stay. Same-day discharge (SDD) in patients after a laparoscopic sleeve gastrectomy (SG) has been described by Surve et al 2018, who performed a large retrospective study of 3162 patients undergoing primary SG in SDD and who found increased morbidity and mortality rates compared to patients who stay for at least one night [4]. However, several small prospective studies assessed SDD after SG using a strict selection of patients did not show increased morbidity and mortality [5][6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Feasibility of Same-Day Discharge After Laparoscopic Roux-en-Y Gastric Bypass Using Remote Monitoring

et al. 2021

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Background Shortening of hospital stay to 1 night has not affected the short-term safety of patients undergoing laparoscopic Roux-en-Y gastric bypass (RYGB). Whether the RYGB is feasible in an ambulatory setting (same-day discharge) without overnight hospital stay remains to be answered. We aimed to evaluate the feasibility of same-day discharge after laparoscopic Roux-en-Y gastric bypass (RYGB) using additional live video consultation and remote monitoring. Same-day discharge (SDD) was defined as surgery without postoperative overnight hospital stay. Methods This was a single-center prospective feasibility study in a selected group of patients undergoing a RYGB. Fifty patients undergoing a primary RYGB were selected and potentially treated following the SDD protocol. After SDD discharge patients were remotely monitored after surgery for 48 h using a medical device measuring vital signs three times a day. Video consultations were performed by a doctor twice a day for 2 postoperative days. Primary outcome was the success rate (%) of SDD. Secondary outcomes were emergency room presentations, readmissions, early complications (<30 days), and patient satisfaction. Results A total of 50 patients were selected for the SDD treatment protocol between June 2020 and November 2020. An SDD success rate of 88 % (44/50 patients) was achieved. Five patients (10%) presented at the emergency room, 2 of whom (4%) were readmitted because of a complication within 30 days after surgery. Overall, patients who followed the SDD protocol reported high satisfaction scores. Conclusion A RYGB with SDD can be considered feasible using remote monitoring for a selected group of patients. Graphical abstract

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