Background

Bariatric Surgery is a safe and effective treatment for morbid obesity. Despite the vast evidence supporting its use, bariatric surgery performed in the inpatient hospital setting can be prohibitively expensive. This study aims to determine whether same-day discharge bariatric surgery can be safely performed with the use of a defined Enhanced Recovery After Bariatric Surgery (ERABS) protocol.

Methods

We performed a retrospective review of same-day bariatric surgeries performed between October 2021 and July 2022 by two high-volume surgeons. Our primary study endpoints included the 30-day rate of ER visits, readmissions, reoperations, morbidity, and mortality. Several statistical analyses were performed, including a non-inferiority analysis with an assigned a non-inferiority margin of 5%.

Results

Out of the 401 patients included, 211 (52.6%) underwent Laparoscopic Roux-En-Y Gastric Bypass (LRYGB), 164 (40.9%) Laparoscopic Sleeve Gastrectomy (LSG), and 26 (6.5%) Laparoscopic Revisional Bariatric Procedures (LRBP). The mean body mass index (BMI) was 46.9 kg/m2. The overall 30-day rate of ER visits was 12.2%, readmissions 2.2%, reoperation 3.5%, and mortality was 0%. By comparison, the nationally accepted rates for these complications are 0.1-10%, 6-20.8%, 4.9-9.8%, and 0-0.01% respectively. Based on our non-inferiority analysis, our results can be considered non-inferior to the standard of care for inpatient bariatric surgery.

Conclusions

Based on our study, outpatient bariatric surgery is associated with non-inferior results with regards to the rate of ER visits, readmissions, reoperations, morbidity, and mortality when utilizing standardized ERABS protocols.