Outpatient laparoscopic sleeve gastrectomy in a free-standing ambulatory surgery center: First 250 cases |
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| Affiliation: | 1. University Hospital Cleveland Medical Center / Case Western Reserve University School of Medicine, Cleveland, OH, USA;2. Department of General, Oncologic, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warszawa, Poland;3. General Surgery Department, Faculty of Medicine, Menoufia University, Al Minufya, Egypt;4. Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland;5. Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, TX, USA;1. Department of Metabolic and Investigative Medicine, Commonwealth building, Hammersmith Hospital, Imperial College London, London, United Kingdom;2. Department of Upper Gastrointestinal and Bariatric Surgery, St George''s Hospital, London, United Kingdom;3. Population Health Research Institute, St George''s, University of London, London, United Kingdom;4. Department of Upper Gastrointestinal and Bariatric Surgery, St George''s Hospital, London, United Kingdom;5. Southmead Hospital, Bristol, United Kingdom;6. Leeds Teaching Hospitals, Leeds, United Kingdom;7. Royal Cornwall Hospital, Treliske, United Kingdom;8. Gloucestershire Hospitals NHS Trust, Cheltenham, United Kingdom;9. Hull and East Yorkshire Hospital, Hull, United Kingdom;10. Dendrite Clinical Systems Ltd, Henley-on-Thames, United Kingdom;11. Queen Alexandra Hospital, Portsmouth, United Kingdom;12. Department of Upper Gastrointestinal and Bariatric Surgery, St George''s Hospital, London, United Kingdom;13. Department of Upper GI and Bariatrics, Hebei Medical University, Hebei Sheng, China;14. Sunderland Hospital, Sunderland, United Kingdom;15. University College Hospital, London, United Kingdom;p. Department of Upper Gastrointestinal and Bariatric Surgery, Musgrove Park Hospital, Taunton, United Kingdom |
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| Abstract: | BackgroundA growing body of evidence supports the laparoscopic sleeve gastrectomy (LSG) as a safe and effective procedure for sustained weight loss and amelioration of weight-related co-morbidities. Procedures performed in ambulatory surgery centers (ASC) can provide several advantages over hospital-based surgery. We present our results of 250 consecutive patients undergoing LSG in an ASC. The objective of this study was to assess the safety and efficacy of outpatient LSG in a freestanding ASC.MethodsData was collected prospectively from 250 consecutive patients who underwent LSG at a freestanding ASC. Patients were excluded from the ASC if they weighed>450 pounds, if anticipated operative time was>2 hours, if the patient had impaired mobility limiting early ambulation, or if there were medical problems requiring postoperative monitoring beyond 23 hours. Revisions were not included in this study.ResultsMean age was 47 years (range, 23–74 yr). Mean preoperative body mass index (BMI) was 43 kg/m² (29–71 kg/m²). Mean operative time was 60 minutes (31–161 min). Mean recovery room time was 131 minutes (30–385 min). Mean percent excess weight loss (%EWL) was 60% at 1 year and 63% at 2 years. Nine patients (3.6%) were readmitted within 30 days. Two patients (.8%) were transferred from the ASC to a hospital. There was 1 staple line leak (.4%). There were no open conversions and no deaths.ConclusionsLSG can be performed safely in a freestanding ASC in select patients with outcomes comparable to the inpatient standard. Additional studies are needed to formulate selection criteria and guidelines to maximize patient safety and outcomes. |
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| Keywords: | Obesity Bariatric surgery Sleeve gastrectomy Outpatient surgery Ambulatory surgery |
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