Outpatient bariatric surgery, as part of Enhanced Recovery After Bariatric Surgery (ERABS) protocols, offers potential benefits in terms of cost reduction, hospital efficiency, and patient satisfaction. However, data on its implementation and safety in private practice settings remain limited. This study aimed to assess the feasibility and safety of a structured outpatient protocol for bariatric surgery incorporating strict eligibility criteria and intensive home follow-up. This prospective, single-center observational study included 237 consecutive patients who underwent sleeve gastrectomy or Roux-en-Y gastric bypass between January 2022 and October 2023. Patients eligible for same-day discharge were under 60 years old, had a BMI < 45 kg/m 2 , ≤ 2 comorbidities, lived within one hour of the clinic, spoke fluent French, and experienced no perioperative complications. The primary outcomes were the rate of successful same-day discharge and 30-day readmission. Length of stay was calculated as 0 days for outpatient cases and 1 day for overnight stays. Outpatient surgery was planned for 79 patients (33.3%), with 76 cases (96.2%) successfully discharged on the day of surgery. No 30-day readmissions occurred among outpatients. Across the entire cohort, five readmissions (2.1%) occurred, all in patients who stayed overnight. The mean hospital stay for all patients was 0.75 days. All outpatient patients received structured home care with nurse visits for an average of 5.7 days. A structured outpatient protocol for bariatric surgery can be safely implemented in private practice. This approach significantly reduces hospital length of stay without increasing early postoperative complications or 30-day readmissions, supporting the integration of outpatient pathways within ERABS protocols for selected patients.
Codre et al. (Mon,) studied this question.