Background

Given the shift toward outpatient settings for surgical interventions, we seek to evaluate the safety profile of laparoscopic Roux-en-y gastric bypass (LRNYGB) performed with same day discharge (SDD). In this paper, we present an in-depth review of the safety outcomes and patient selection criteria used to perform LRNYGB in a SDD setting at a single institution. This review illuminates the safety considerations inherent in SDD LRNYGB, adding to the growing body of evidence guiding clinicians in optimizing the safe performance of this gold-standard bariatric procedure.

Methods

Retrospective review of LRNYGB performed by one high-volume surgeon at a single institution between November 2021 and October 2023. All patients underwent LRNYGB with SDD after completing online module-based education. The primary outcome was evaluation of the safety of routinely performing this procedure with SDD. The secondary outcome was to aid in developing a pathway for patient selection and perioperative management.

Results

In total, 252 cases were reviewed. Of these, 4 (1.59%) of patients were admitted to a hospital within 30 days of discharge. 0.79% of patients required outpatient IV hydration. There were no mortalities. The average BMI was 43.75 kg/m2. 80.56% of patients were ASA III, and 19.44% ASA II. Common preoperative morbidities included Diabetes mellitus (27.78%), OSA (25.79%), GERD (24.6%), hypertension (37.3%), and hyperlipidemia (24.60%).

Conclusions

With an established perioperative treatment pathway and judicious patient selection, LRNYGB may safely be routinely performed with SDD. The low rates of readmission underscore the success and feasibility of this approach.