Outpatient Gastric Sleeve Surgery: Medium-Term Outcome
Rui Torres1 , Rita Sá1 , Carmélia Ferreira

A perioperative protocol for patients undergoing laparoscopic sleeve gastrectomy as outpatients has been implemented in our hospital, with the following key features:

Preoperative: Pre-anesthetic consultation 3 sessions with a rehabilitation nurse for respiratory training, cough exercises, smoking cessation support, and promoting physical activity and weight loss

Intraoperative: Multimodal analgesia Alveolar recruitment maneuvers to minimize respiratory complications

Postoperative: Rehabilitation initiated 6 hours post-surgery Follow-up phone calls on days 1, 2, 5, 7, 10, and 30 to monitor recovery, assess pain, and reinforce lifestyle changes

Hypothesis: Outpatient surgery improves medium-term outcomes in lifestyle, quality of life, and comorbidities.

Methods: Inclusion: Age 18-55, BMI <45, ASA II/III Exclusion: Cardiac disease, chronic kidney disease, severe obstructive sleep apnea not adapted to CPAP, poorly controlled diabetes mellitus, chronic liver disease, redo surgeries Data collection: 17 months post-surgery via online survey

Results: There were no statistically significant differences in age, gender, or smoking habits between the groups The outpatient group had a greater median reduction in BMI (16 vs. 12) and more weekly exercise hours (7 vs. 3), though these differences were not statistically significant Both groups had similar BDI-II and SF-36 scores

Discussion/conclusion: ✓ Protocol is practicable and safe ✓ Quality of life and mental health outcomes were similar across groups ✓ Outpatients showed greater BMI reduction and higher physical activity, but results weren’t statistically significant. Nevertheless, encouraging physical activity and healthy lifestyle changes as part of perioperative care may enhance patient adherence and outcomes

References: Stenberg E, Dos Reis Falcão LF, O'Kane M, et al. Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations: A 2021 Update [published correction appears in World J Surg. 2022 Jan 29;:]. World J Surg. 2022;46(4):729-751. doi:10.1007/s00268-021-06394-