Laparoscopic sleeve gastrectomy as day-case ambulatory surgery
EAES Academy. Soares-Moreira P. 07/05/22; 362972; P015
Dr. Pedro Soares-Moreira
Contributions
Contributions
Abstract
Background:
In recent years we have observed a progressive trend towards increasing complexity in ambulatory surgery. This is due to clinical and economic benefits and soundly supported by safety studies. However, day-case bariatric surgery remains controversial due to conflicting reports and absence of high-quality evidence. Laparoscopic sleeve gastrectomy has been increasingly performed as day-case surgery and proved safe in prospective studies. Nonetheless, it has yet to gain acceptance of the international bariatric surgical community. Since sleeve gastrectomy is currently the most frequently performed bariatric surgery worldwide, the authors describe their experience with a pilot study of day-case sleeve gastrectomy.
Methods:
Obese patients that met simultaneous criteria for bariatric surgery (body mass index (BMI) >40Kg/m2 or BMI>35Kg/m2 with comorbidities) and outpatient surgery were considered eligible. Patients that were proposed to gastric sleeve were further screened for ambulatory sleeve gastrectomy. Exclusion criteria were: previous abdominal surgery, anticoagulant or anti-platelet therapy and uncompensated T2DM or sleep apnea.
Patients were enrolled between April and November, 2021. All patients were instructed to use and record vital signs using a portable device after discharge. Patients were interviewed by phone on the 1st post-operative day (POD) and seen at outpatient clinic at POD 2 and 30. A satisfaction questionnaire was conducted by telephone.
Results:
Fifteen patients underwent day-case sleeve gastrectomy during this period. Mean age was 46 years old (range 21-67) and 83% were female. Median BMI was 41.5 kg/m2 (range 38.3-48.4) and 93% had obesity-related comorbidities. Mean operative time was 50 minutes (range 38-67). There were no intraoperative surgical/anesthetic complications. One patient stayed overnight due to intolerance to liquids in the first post-operative hours and was discharged at the following morning and one patient was admitted due to a suspected angina, with a negative workup. No post-operative complications occurred and there were no 30-day readmissions. Global satisfaction was graded 4,8/5 by all patients, all would choose day-case surgery again and recommend it to other bariatric patients.
Conclusion:
This pilot study supports previous reports that day-case ambulatory sleeve gastrectomy is safe, possible and associated with excellent patient satisfaction.
In recent years we have observed a progressive trend towards increasing complexity in ambulatory surgery. This is due to clinical and economic benefits and soundly supported by safety studies. However, day-case bariatric surgery remains controversial due to conflicting reports and absence of high-quality evidence. Laparoscopic sleeve gastrectomy has been increasingly performed as day-case surgery and proved safe in prospective studies. Nonetheless, it has yet to gain acceptance of the international bariatric surgical community. Since sleeve gastrectomy is currently the most frequently performed bariatric surgery worldwide, the authors describe their experience with a pilot study of day-case sleeve gastrectomy.
Methods:
Obese patients that met simultaneous criteria for bariatric surgery (body mass index (BMI) >40Kg/m2 or BMI>35Kg/m2 with comorbidities) and outpatient surgery were considered eligible. Patients that were proposed to gastric sleeve were further screened for ambulatory sleeve gastrectomy. Exclusion criteria were: previous abdominal surgery, anticoagulant or anti-platelet therapy and uncompensated T2DM or sleep apnea.
Patients were enrolled between April and November, 2021. All patients were instructed to use and record vital signs using a portable device after discharge. Patients were interviewed by phone on the 1st post-operative day (POD) and seen at outpatient clinic at POD 2 and 30. A satisfaction questionnaire was conducted by telephone.
Results:
Fifteen patients underwent day-case sleeve gastrectomy during this period. Mean age was 46 years old (range 21-67) and 83% were female. Median BMI was 41.5 kg/m2 (range 38.3-48.4) and 93% had obesity-related comorbidities. Mean operative time was 50 minutes (range 38-67). There were no intraoperative surgical/anesthetic complications. One patient stayed overnight due to intolerance to liquids in the first post-operative hours and was discharged at the following morning and one patient was admitted due to a suspected angina, with a negative workup. No post-operative complications occurred and there were no 30-day readmissions. Global satisfaction was graded 4,8/5 by all patients, all would choose day-case surgery again and recommend it to other bariatric patients.
Conclusion:
This pilot study supports previous reports that day-case ambulatory sleeve gastrectomy is safe, possible and associated with excellent patient satisfaction.
Background:
In recent years we have observed a progressive trend towards increasing complexity in ambulatory surgery. This is due to clinical and economic benefits and soundly supported by safety studies. However, day-case bariatric surgery remains controversial due to conflicting reports and absence of high-quality evidence. Laparoscopic sleeve gastrectomy has been increasingly performed as day-case surgery and proved safe in prospective studies. Nonetheless, it has yet to gain acceptance of the international bariatric surgical community. Since sleeve gastrectomy is currently the most frequently performed bariatric surgery worldwide, the authors describe their experience with a pilot study of day-case sleeve gastrectomy.
Methods:
Obese patients that met simultaneous criteria for bariatric surgery (body mass index (BMI) >40Kg/m2 or BMI>35Kg/m2 with comorbidities) and outpatient surgery were considered eligible. Patients that were proposed to gastric sleeve were further screened for ambulatory sleeve gastrectomy. Exclusion criteria were: previous abdominal surgery, anticoagulant or anti-platelet therapy and uncompensated T2DM or sleep apnea.
Patients were enrolled between April and November, 2021. All patients were instructed to use and record vital signs using a portable device after discharge. Patients were interviewed by phone on the 1st post-operative day (POD) and seen at outpatient clinic at POD 2 and 30. A satisfaction questionnaire was conducted by telephone.
Results:
Fifteen patients underwent day-case sleeve gastrectomy during this period. Mean age was 46 years old (range 21-67) and 83% were female. Median BMI was 41.5 kg/m2 (range 38.3-48.4) and 93% had obesity-related comorbidities. Mean operative time was 50 minutes (range 38-67). There were no intraoperative surgical/anesthetic complications. One patient stayed overnight due to intolerance to liquids in the first post-operative hours and was discharged at the following morning and one patient was admitted due to a suspected angina, with a negative workup. No post-operative complications occurred and there were no 30-day readmissions. Global satisfaction was graded 4,8/5 by all patients, all would choose day-case surgery again and recommend it to other bariatric patients.
Conclusion:
This pilot study supports previous reports that day-case ambulatory sleeve gastrectomy is safe, possible and associated with excellent patient satisfaction.
In recent years we have observed a progressive trend towards increasing complexity in ambulatory surgery. This is due to clinical and economic benefits and soundly supported by safety studies. However, day-case bariatric surgery remains controversial due to conflicting reports and absence of high-quality evidence. Laparoscopic sleeve gastrectomy has been increasingly performed as day-case surgery and proved safe in prospective studies. Nonetheless, it has yet to gain acceptance of the international bariatric surgical community. Since sleeve gastrectomy is currently the most frequently performed bariatric surgery worldwide, the authors describe their experience with a pilot study of day-case sleeve gastrectomy.
Methods:
Obese patients that met simultaneous criteria for bariatric surgery (body mass index (BMI) >40Kg/m2 or BMI>35Kg/m2 with comorbidities) and outpatient surgery were considered eligible. Patients that were proposed to gastric sleeve were further screened for ambulatory sleeve gastrectomy. Exclusion criteria were: previous abdominal surgery, anticoagulant or anti-platelet therapy and uncompensated T2DM or sleep apnea.
Patients were enrolled between April and November, 2021. All patients were instructed to use and record vital signs using a portable device after discharge. Patients were interviewed by phone on the 1st post-operative day (POD) and seen at outpatient clinic at POD 2 and 30. A satisfaction questionnaire was conducted by telephone.
Results:
Fifteen patients underwent day-case sleeve gastrectomy during this period. Mean age was 46 years old (range 21-67) and 83% were female. Median BMI was 41.5 kg/m2 (range 38.3-48.4) and 93% had obesity-related comorbidities. Mean operative time was 50 minutes (range 38-67). There were no intraoperative surgical/anesthetic complications. One patient stayed overnight due to intolerance to liquids in the first post-operative hours and was discharged at the following morning and one patient was admitted due to a suspected angina, with a negative workup. No post-operative complications occurred and there were no 30-day readmissions. Global satisfaction was graded 4,8/5 by all patients, all would choose day-case surgery again and recommend it to other bariatric patients.
Conclusion:
This pilot study supports previous reports that day-case ambulatory sleeve gastrectomy is safe, possible and associated with excellent patient satisfaction.
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