Safety of Same-Day Discharge Bariatric Surgery: A Comprehensive Analysis of 457 Cases Across Multiple Procedure Types.

Abstract

Background: Outpatient bariatric surgery offers reduced hospital stays and healthcare costs, with promising safety outcomes. This study analyzes the short-term results of stand-alone primary and revision bariatric surgeries, alongside concomitant foregut and abdominal surgeries associated with bariatric procedures, to assess their safety and efficacy in an outpatient setting at a free-standing ambulatory center.

Methods: A retrospective study was conducted on 457 same-day discharge (SDD) bariatric cases performed by a single surgeon at a free-standing ambulatory center between January 2021 and July 2024. The procedures included sleeve gastrectomy (SG), duodenal switch (DS), adjustable gastric band (AGB) removal, and Roux-en-Y gastric bypass (RYGB). Concomitant foregut and abdominal surgeries associated with bariatric procedures, such as hiatal hernia repair (HHR), cholecystectomy, fundoplication, and ventral hernia repair, were performed when clinically indicated.

Results: Of the 457 cases, 97.8% were primary surgeries, and 2.1% were revisions. Stand-alone procedures accounted for 39.3%, and 60.6% were concomitant. SG constituted 74.8% of cases, followed by HHR (16.1%), DS (5.4%), AGB removal (2.6%), and RYGB (.8%). The mean operative time was 79.9 ± 24.3 min, with a mean length of stay of 3 h 52 min (± 1:10). The 30-day complication rate was 2.1%, with Clavien-Dindo grade IIIb complications in .8% of patients. Patient satisfaction was high, with a mean score of 9.8.

Conclusions: Outpatient bariatric surgeries demonstrated strong safety with minimal complications, underscoring their viability in carefully selected patients. Staged approaches for complex cases further optimized outcomes, making outpatient settings a robust option for a wide range of bariatric procedures.