Background

Sleeve gastrectomy (SG) is the most common bariatric procedure performed. Because it has a short operative time and good risk profile, it makes this surgery a safe option for same day discharge.

Methods

A retrospective review/prospective date collection was performed on 516 consecutive patients who underwent SG from March 2022 to October 2023. All surgeries were performed in a single center, single specialty, freestanding ambulatory surgery center (ASC) by a multi-surgeon private practice group. Patient selection followed MBSAQIP low acuity center criteria (see image). Peri-operative protocols were universalized based on most recent ERAS protocols (see table). Patients were discharged within 4 hours of surgery. Demographics, comorbidities, wound occurrences, major complications, transfers to the hospital, emergency room (ER) visits within 36 hours of discharge, and hospital admissions within 30 days were tracked.

Results

See image for patient demographics and comorbidities. Complications were 5 wound occurrences (4 being infectious), 2 portal vein thromboses, 1 pneumonia, 1 acute myocardial infarction, and 1 new onset atrial fibrillation. There were no episodes of bleeding or blood transfusions, leaks, or mortalities. 1 transfer to the ER occurred due to the patient having suicidal ideation postoperatively. The only reoperation was a diagnostic laparoscopy from the recovery room due to a syncopal episode and suspected bleed. There were 3(0.06%) ER visits within 36 hours and 11(2%) Hospital admissions within 30 days.

Conclusions

SG can be performed safely in the outpatient setting with appropriately selected patients. Standardization of protocols is a key factor in optimizing outcomes.