Background

Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S), an effective weight-loss surgery for morbid obesity, has established safety profiles in in-patient hospital settings. However, its safety in outpatient settings with same-day discharge remains inadequately explored.Objective To assess the short-term safety of primary SADI-S procedures conducted in outpatient settings by evaluating 30-day postoperative outcomes.

Methods

A retrospective analysis was performed using data from a prospectively maintained database, encompassing 305 instances of outpatient primary SADI-S procedures conducted between May 2020 and January 2023. These procedures were carried out by five surgeons at two distinct U.S. surgical centers. Notably, no standardized surgical techniques or enhanced recovery after surgery protocols were implemented across these centers.

Results

A total of 305 patients were included in the final analysis. The mean preoperative BMI was 46 +- 6.6 kg/m2. Preoperative hypertension (24.9%), obstructive sleep apnea (27.5%), type 2 diabetes (17%), hyperlipidemia (19%), and gastroesophageal reflux disease (18.3%) were observed in the patient cohort. Intraoperative complications occurred in 0.3% of cases, with no instances of open conversion. The mean skin-to-skin operative time was 61.2 +- 18.9 minutes, and the average length of stay was 5 hours and 30 minutes +- 1 hour and 10 minutes. We observed a 3.9% rate of complications, 0.9% for both readmissions and reoperations within the initial 30 days, alongside a 1.3% emergency room visit rate and a 1.6% reintervention rate. No deaths were recorded.

Conclusions

In carefully selected patients, outpatient single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) demonstrated favorable short-term safety outcomes.