Implementing a day-case gastric bypass program: a retrospective feasibility study
Ahmed Gendia, Rosanna Clarke-Burns, Lisa Bowen, Omar KhanBackground:
Same-day discharge (SDD) after Roux-en-Y gastric bypass (RYGB) remains uncommon, particularly within publicly funded healthcare systems where dedicated day-case pathways are limited. This study evaluates the feasibility and safety of performing RYGB as a day-case procedure within a standard day surgery unit without on-site high-dependency facilities.
Methods:
This retrospective feasibility cohort study was conducted across two National Health Service bariatric centers. Patients were identified from bariatric waiting lists and retrospectively assessed against predefined selection criteria (BMI <45 kg/m 2 , age <50 years; and absence of insulin-dependent diabetes, CPAP dependence, anticoagulation, or prior major abdominal surgery). Eligible patients underwent RYGB within a standardized SDD pathway.
Results:
Eighty-five patients were screened, of whom 11 (12.9%) met the eligibility criteria. One patient’s operation was canceled on the day of surgery, and 10 proceeded to surgery. One procedure was abandoned intra-operatively due to hepatomegaly, leaving nine completed RYGB procedures. Seven patients (77.8%) achieved successful SDD. Two patients required overnight admission due to postoperative nausea and delayed mobilization. There were no 30-day readmissions, surgical complications, or emergency department attendances.
Conclusions:
SDD RYGB is feasible and safe in carefully selected low-risk patients within a publicly funded healthcare system, even in the absence of on-site high-dependency support. This approach may improve efficiency and resource utilization within bariatric surgery pathways.