Advertisement

Bariatric surgeon perceptions of the safety of same-day sleeve gastrectomy in the state of Massachusetts

Published:November 01, 2022DOI:https://doi.org/10.1016/j.soard.2022.10.026

      Highlights

      • Most bariatric surgeons in Massachusetts are reluctant to perform SDSG.
      • Some bariatric surgeons consider SDSG to be a safe procedure in well-selected patients.
      • Safety considerations limiting SDSG application included significant distance of patients' home from the hospital, patients who live alone, and patients who are non-ambulatory.

      Abstract

      Background

      During the past 2.5 years, select bariatric surgeons in the Commonwealth of Massachusetts have been implementing same-day sleeve gastrectomy (SDSG). Key reasons for this change have been to reduce risks associated with hospitalization in the context of the COVID-19 pandemic and to comply with third-party payer preference to reduce costs.

      Objective

      We aimed to evaluate bariatric surgeons’ attitudes about outcomes and morbidity between patients who are hospitalized after sleeve gastrectomy and patients who undergo SDSG.

      Setting

      Beth Israel Deaconess Medical Center in Boston, Massachusetts (teaching hospital of Harvard Medical School).

      Methods

      This prospective cohort study was conducted among bariatric surgeons practicing in the Commonwealth of Massachusetts. An anonymous web-based questionnaire was distributed using the Research Electronic Data Capture software. A total of 58 bariatric surgeons in Massachusetts were identified and successfully contacted based on registration with the Massachusetts Board of Registration in Medicine, membership in the American Society for Metabolic and Bariatric Surgery, and internet search.

      Results

      A total of 33 bariatric surgeons in Massachusetts completed the survey, yielding a response rate of 56.9%. Among the respondents, 75.76% have not performed SDSG, reporting patient safety as the major concern, and 24.24% had performed SDSG in the past.

      Conclusion

      Survey responses showed no significant differences in surgeon perception between SDSG and hospitalization after surgery. Optimal patient selection was an important factor influencing surgeons’ decisions with regard to performing SDSG. However, bariatric surgeons in Massachusetts are reluctant to perform SDSG.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Surgery for Obesity and Related Diseases
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Palermo M.
        • Serra E.
        Laparoscopic sleeve gastrectomy: how do I do it.
        J Laparoendosc Adv Surg Tech A. 2020; 30: 2-5
        • Valente M.
        • Campanelli M.
        • Benavoli D.
        • et al.
        Safety and outcomes of laparoscopic sleeve gastrectomy in a general surgery residency program.
        JSLS. 2021; 25 (e2020.00063)
        • Wang F.-G.
        • Yu Z.-P.
        • Yan W.-M.
        • Yan M.
        • Song M.-M.
        Comparison of safety and effectiveness between laparoscopic mini-gastric bypass and laparoscopic sleeve gastrectomy: a meta-analysis and systematic review.
        Medicine. 2017; 96e8924
        • Giordano S.
        • Salminen P.
        Laparoscopic sleeve gastrectomy is safe for patients over 60 years of age: a meta-analysis of comparative studies.
        J Laparoendosc Adv Surg Tech A. 2020; 30: 12-19
        • Billing P.S.
        • Crouthamel M.R.
        • Oling S.
        • Landerholm R.W.
        Outpatient laparoscopic sleeve gastrectomy in a free-standing ambulatory surgery center: first 250 cases.
        Surg Obes Relat Dis. 2014; 10: 101-105
        • Garofalo F.
        • Pescarus R.
        • Denis R.
        • et al.
        Laparoscopic sleeve gastrectomy: a radiological guide to common postsurgical failure.
        Can Assoc Radiol J. 2018; 69: 184-196
        • Dreifuss N.H.
        • Xie J.
        • Schlottmann F.
        • et al.
        Risk factors for readmission after same-day discharge sleeve gastrectomy: a metabolic and bariatric surgery accreditation and quality improvement program database analysis.
        Obes Surg. 2022; 32: 962-969
        • Barbat S.
        • Thompson K.J.
        • Mckillop I.H.
        • Kuwada T.S.
        • Gersin K.
        • Nimeri A.
        Ambulatory bariatric surgery: does it really lead to higher rates of adverse events?.
        Surg Obes Relat Dis. 2020; 16: 1713-1720
        • Nossaman V.
        • Grinberg G.
        • Yenumula P.
        Impact of COVID-19 pandemic on same day discharge sleeve gastrectomy, a retrospective review of 172 patients.
        J Am Coll Surg. 2021; 233: e6
        • Nahshon C.
        • Bitterman A.
        • Haddad R.
        • Hazzan D.
        • Lavie O.
        Hazardous postoperative outcomes of unexpected COVID-19 infected patients: a call for global consideration of sampling all asymptomatic patients before surgical treatment.
        World J Surg. 2020; 44: 2477-2481
        • Gebran S.G.
        • Knighton B.
        • Ngaage L.M.
        • et al.
        Insurance coverage criteria for bariatric surgery: a survey of policies.
        Obes Surg. 2020; 30: 707-713
        • Inaba C.S.
        • Koh C.Y.
        • Sujatha-Bhaskar S.
        • Pejcinovska M.
        • Nguyen N.T.
        How safe is same-day discharge after laparoscopic sleeve gastrectomy?.
        Surg Obes Relat Dis. 2018; 14: 1448-1453
        • Badaoui R.
        • Alami Chentoufi Y.
        • Hchikat A.
        • et al.
        Outpatient laparoscopic sleeve gastrectomy: first 100 cases.
        J Clin Anesth. 2016; 34: 85-90
        • Ghanem O.M.
        • Clapp B.
        Comment on: Comparison of safety and utilization outcomes in inpatient versus outpatient laparoscopic sleeve gastrectomy: a retrospective, cohort study.
        Surg Obes Relat Dis. 2020; 16: 1671-1672
        • Fortin S.P.
        • Kalsekar I.
        • Johnston S.
        • Akincigil A.
        Comparison of safety and utilization outcomes in inpatient versus outpatient laparoscopic sleeve gastrectomy: a retrospective, cohort study.
        Surg Obes Relat Dis. 2020; 16: 1661-1671
        • Horn S.R.
        • Segreto F.A.
        • Alas H.
        • et al.
        Hospital-acquired conditions occur more frequently in elective spine surgery than for other common elective surgical procedures.
        J Clin Neurosci. 2020; 76: 36-40
        • Santry H.P.
        • Gillen D.L.
        • Lauderdale D.S.
        Trends in bariatric surgical procedures.
        JAMA. 2005; 294: 1909-1917
        • Gagner M.
        Comments on: Factors implicated in discharge disposition following elective bariatric surgery.
        Surg Obes Relat Dis. 2021; 17: 111-112
        • Lalezari S.
        • Musielak M.C.
        • Broun L.A.
        • Curry T.W.
        Laparoscopic sleeve gastrectomy as a viable option for an ambulatory surgical procedure: our 52-month experience.
        Surg Obes Relat Dis. 2018; 14: 748-750
        • Rebibo L.
        • Dhahri A.
        • Badaoui R.
        • Hubert V.
        • Lorne E.
        • Regimbeau J.-M.
        Laparoscopic sleeve gastrectomy as day-case surgery: a case-matched study.
        Surg Obes Relat Dis. 2019; 15: 534-545
        • Billing P.
        • Billing J.
        • Harris E.
        • Kaufman J.
        • Landerholm R.
        • Stewart K.
        Safety and efficacy of outpatient sleeve gastrectomy: 2534 cases performed in a single free-standing ambulatory surgical center.
        Surg Obes Relat Dis. 2019; 15: 832-836
        • Alqahtani A.R.
        • Elahmedi M.
        • Amro N.
        • et al.
        Laparoscopic sleeve gastrectomy as day-case surgery versus conventional hospitalization: results of the DAYSLEEVE randomized clinical trial.
        Surg Obes Relat Dis. 2022; 18: 1141-1149
        • Aryaie A.H.
        • Reddy V.
        • Dattilo Z.
        • Janik M.R.
        Safety of same-day discharge after laparoscopic sleeve gastrectomy: propensity score-matched analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program registry.
        Surg Obes Relat Dis. 2021; 17: 46-53
        • Singh R.
        • Musielak M.
        • Shahid H.
        • Curry T.
        Same-day discharge after laparoscopic sleeve gastrectomy: our initial experience.
        Am Surg. 2014; 80: 1274-1276