Outpatient Bariatric Surgery: Is It Possible?
Seance of wednesday 27 may 2026 (Chirurgie bariatrique: l'Académie reçoit la SOFFCO-MM - La chirurgie métabolique et bariatrique à l’ère des nouvelles thérapies médicamenteuses)
DOI number : 10.26299/pbk9-vb79/emem.2026.22.05
Abstract
In his report presented at the 119th Congrès Français de Chirurgie, Pr Johanet highlighted the limited uptake of outpatient surgery in France and questioned which levers — incentive or constraint — might best drive its development. In our case, constraint was the driving force: faced with insufficient inpatient bed capacity, we progressively developed a dedicated organisational framework for outpatient care.
Following a stepwise progression — adjustable gastric banding, sleeve gastrectomy, then Roux-en-Y gastric bypass — more than 80% of our major bariatric procedures are now performed on an outpatient basis. In a consecutive series of 2,580 sleeve gastrectomies (2019–2024), 2,207 procedures were conducted as true day-surgery (85.5%), with zero mortality, a 30-day complication rate of 4.2%, and an unplanned overnight admission rate of 10.2%, showing continuous improvement over time.
This model relies on genuine outpatient care — same-day discharge without home nursing or home hospitalisation — built upon three conditions: an outpatient-first philosophy, a rigorous ERAS protocol, and structured digital monitoring (day 0 to day 10).
These data demonstrate that outpatient bariatric surgery is achievable. Beyond feasibility, it enhances patient safety and contributes meaningfully to reducing healthcare expenditure. They may thus provide a sound foundation for broader implementation across accredited centres.
Following a stepwise progression — adjustable gastric banding, sleeve gastrectomy, then Roux-en-Y gastric bypass — more than 80% of our major bariatric procedures are now performed on an outpatient basis. In a consecutive series of 2,580 sleeve gastrectomies (2019–2024), 2,207 procedures were conducted as true day-surgery (85.5%), with zero mortality, a 30-day complication rate of 4.2%, and an unplanned overnight admission rate of 10.2%, showing continuous improvement over time.
This model relies on genuine outpatient care — same-day discharge without home nursing or home hospitalisation — built upon three conditions: an outpatient-first philosophy, a rigorous ERAS protocol, and structured digital monitoring (day 0 to day 10).
These data demonstrate that outpatient bariatric surgery is achievable. Beyond feasibility, it enhances patient safety and contributes meaningfully to reducing healthcare expenditure. They may thus provide a sound foundation for broader implementation across accredited centres.