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Feasibility of same-day discharge after laparoscopic sleeve gastrectomy in the Netherlands

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Abstract

Background

There is a trend towards laparoscopic sleeve gastrectomy (SG) with same-day discharge (SDD), as an efficient healthcare pathway to alleviate the burden on clinical capacity. This approach seems to be safe, if patients are carefully selected. In our bariatric center, a protocol for Roux-en-Y gastric bypass with SDD has already been successfully implemented. The aim of this study was to evaluate feasibility of applying the same SDD protocol for SG.

Methods

A single-center prospective feasibility study was conducted at a high-volume bariatric center. Low-risk patients who were scheduled for primary SG were included. Strict criteria were used for approval upon SDD. The primary outcome was the rate of successful SDD without readmission within 48 h. Secondary outcomes included short-term complications, emergency department visits, readmissions, and mortality.

Results

Fifty patients were included in the study, of whom 45 were successfully discharged on the same day of the surgery. Nausea and vomiting were the most common reasons for overnight hospitalization (three patients). One patient was readmitted within the first 48 h due to a mild complication related to bleeding, resulting in a success rate of 88% for SDD without readmission within 48 h. No severe complications or mortality were reported in the cohort.

Conclusion

Our SDD protocol for SG has demonstrated feasibility, with a high success rate of SDD and no severe complications. Strict conditions should be met for the safe implementation of a SDD protocol, including careful patient selection and the establishment of a safety net to detect early complications.

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Authors and Affiliations

  1. Department of Surgery, OLVG Hospital, Jan Tooropstraat 164, 1061 AE, Amsterdam, The Netherlands

    Suzanne C. Kleipool, Pim W. J. van Rutte, Steve M. M. de Castro & Ruben N. van Veen

  2. Department of Anesthesiology, OLVG Hospital, Amsterdam, The Netherlands

    Marlou Vogel

  3. Department of Surgery, Amsterdam UMC, Amsterdam, The Netherlands

    H. Jaap Bonjer

Authors
  1. Suzanne C. Kleipool
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  2. Pim W. J. van Rutte
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  3. Marlou Vogel
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  4. H. Jaap Bonjer
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  5. Steve M. M. de Castro
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  6. Ruben N. van Veen
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Corresponding author

Correspondence to Suzanne C. Kleipool.

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Disclosures

Suzanne C. Kleipool, Pim W.J. van Rutte, Marlou Vogel, H. Jaap Bonjer, Steve M.M. de Castro and Ruben N. van Veen have no conflicts of interest or financial ties to disclose.

Ethical approval

This study has received approval from the Medical Ethical Review Committee, and all procedures have been conducted in adherence to the principles outlined in the Declaration of Helsinki, initially adopted in 1964, and its subsequent amendments, or comparable ethical standards.

Informed consent

Informed consent was obtained from each individual participant included in the study, and all patients voluntarily participated.

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Kleipool, S.C., van Rutte, P.W.J., Vogel, M. et al. Feasibility of same-day discharge after laparoscopic sleeve gastrectomy in the Netherlands. Surg Endosc 38, 872–879 (2024). https://doi.org/10.1007/s00464-023-10590-0

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