Bariatric surgery is a very effective intervention for individuals with severe obesity, leading to significant and sustained weight loss, improvement in comorbid conditions, and enhanced quality of life 1. Traditionally, bariatric surgery has been performed as an inpatient procedure, requiring patients to stay in the hospital for a few days post-operation. However, advancements in surgical techniques, anesthesia, and postoperative care have turned outpatient bariatric surgery into a viable option for some patients. Patients and their physicians must determine whether inpatient or outpatient bariatric surgery is the best option for them.
Inpatient bariatric surgery involves admitting the patient to the hospital for at least one night post-surgery. Often, this is done for more complex procedures or patients with higher risk profiles. Inpatient surgery allows for enhanced postoperative monitoring and immediate intervention if complications arise, which is particularly important for patients with significant comorbidities or those undergoing more complex procedures. In addition, patients receive comprehensive care, including pain management, nutritional support, and physical therapy, which can improve recovery outcomes. The hospital environment also provides a controlled setting with access to advanced medical equipment and specialists, enhancing overall patient safety 2.
However, inpatient surgery is generally more expensive than outpatient surgery across procedures, including bariatric surgery, due to the extended hospital stay and additional resources required—for high-risk patients though, the increased cost is justified by the enhanced safety and monitoring 3,4. Furthermore, a longer hospital stay can be inconvenient for patients and may increase the risk of hospital-acquired infections 5.
Outpatient bariatric surgery, also known as same-day surgery or ambulatory surgery, involves performing the surgical procedure with the expectation that the patient will be discharged within 24 hours—this is typically reserved for less complex procedures and patients with lower risk profiles.
The most significant advantage of outpatient bariatric surgery is removing the hospital stay 6. Patients can return to the comfort of their homes on the same day 4, which can improve patient psychological well-being and reduce the risk of hospital-acquired infections. In general, patients may find outpatient bariatric surgery thus more convenient than inpatient, as it reduces the disruption to their lives. In addition, outpatient bariatric surgery is generally more cost-effective compared to inpatient surgery due to the reduced need for prolonged hospital stays and associated resources 4.
Not all patients are suitable candidates for outpatient bariatric surgery, as the outpatient setting has reduced access to certain medical services 3. Ideal candidates are therefore typically younger, have a lower body mass index (BMI), and fewer comorbidities—comprehensive preoperative evaluation and risk stratification are essential. Furthermore, ensuring adequate postoperative care is crucial for outpatient procedures, since patients must have access to appropriate follow-up care, including emergency services if complications arise 4.
In conclusion, both outpatient and inpatient bariatric surgery have their unique advantages and considerations. In the end, the choice depends on patient-specific factors, the complexity of the procedure, and the availability of postoperative support.
References
1. Bariatric surgery – Mayo Clinic. Available at: https://www.mayoclinic.org/tests-procedures/bariatric-surgery/about/pac-20394258.
2. Is Bariatric Surgery Inpatient or Outpatient? – Acibadem Health Point International. Available at: https://www.acibademhealthpoint.com/the-is-bariatric-surgery-inpatient-or-outpatient/.
3. Can the Gastric Sleeve Be Performed as Outpatient Surgery? Available at: https://www.masjax.com/gastric-sleeve-performed-on-an-outpatient-basis/.
4. How does outpatient gastric sleeve surgery differ from inpatient procedures? Available at: https://gastricsleevelife.com/how-does-outpatient-gastric-sleeve-surgery-differ-from-inpatient-procedures/.
5. Khan, H. A., Baig, F. K. & Mehboob, R. Nosocomial infections: Epidemiology, prevention, control and surveillance. Asian Pacific Journal of Tropical Biomedicine (2017). doi:10.1016/j.apjtb.2017.01.019
6. 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). doi:10.1016/j.soard.2020.07.012