• Skip to primary navigation
  • Skip to main content
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • SAGES Store
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
    • “Unofficial” Logo Products
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2024 Scientific Session Call For Abstracts
      • 2024 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Fellows Career Development Course
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • OWLS
  • Log In

The Impact of Enhanced Recovery Protocol for Patients Undergoing Bariatric Laparoscopic Sleeve Gastrectomy

Katelyn Mellion, MD, Katie Meister, MD, Anna Uebele, MD, Lala Hussain, Kevin Tymitz, MD, George Kerlakian, MD. Good Samaritan Hospital

Introduction: Enhanced recovery protocols (ERP) standardize perioperative patient care in an effort to hasten recovery by minimizing the stress response of surgery, improving pain control, and accelerating gastrointestinal function. The purpose of this study is to evaluate the outcome of implementing an ERP for bariatric patients undergoing laparoscopic sleeve gastrectomy (LSG). 

Methods and Procedures: The bariatric ERP was created to address the specific needs of morbidly obese patients undergoing foregut surgery. Specific modalities include: extensive preoperative patient education, regimented oral hydration until 3 hours preoperatively, multimodal pain management (pregabalin and celecoxib preoperatively, narcotic and non-narcotic analgesia postoperatively), judicious use of perioperative intravenous fluids, and early Foley catheter removal, ambulation, and enteral feeding. This retrospective study examines outcomes of bariatric LSG specific ERP from January 2013 to June 2015. Exclusion criteria include patients who underwent LSG for reasons other than weight loss, whose procedure was abandoned, or who concomitantly underwent another procedure. Demographic data include: age, gender, preoperative body mass index (BMI), preoperative comorbidities, American Society of Anesthesiologists (ASA) class. Outcome variables include: length of stay (LOS), 30-day readmission, 30-day reoperation, 30-day ICU admission. Mann Whitney U and Fisher's Exact tests were used to determine the effect of preoperative comorbidities on patient LOS and 30-day readmission, respectively. 30-day readmission rate was compared between patients before and after ERP implementation with Chi-square test. P<0.05 was deemed statistically significant.

Results: A total of 88 patients were analyzed. Average age and preoperative BMI were 45.7 (10.9) years and 44.6 (9.8) kg/m2, respectively. The cohort was 15.9% male. Preoperative comorbidities included: diabetes (15.9%), hypertension (33.0%), history of pulmonary embolism (1.1%), cardiovascular disease (0%), chronic obstructive pulmonary disease (2.3%), gastroesophageal reflux (22.7%), tobacco use (9.1%), severe limitation to ambulation (3.4%). The ASA classes of patients undergoing LSG were II (21.6%), III (77.3%), and IV (1.1%). Average LOS, 30-day readmission, 30-day reoperation, and 30-day ICU admission were 2.09 days, 8.0%, 0%, and 0%, respectively. Patients with hypertension were more likely to be readmitted within 30 days (p=0.037). 30-day readmission rate prior to ERP implementation was 16.2% vs 8% after (p=0.111).

Conclusion: We have reported outcomes of using an ERP specific to bariatric patients undergoing LSG. There is a trend toward fewer readmissions in ERP patients compared to patients undergoing LSG without an ERP. Patients with hypertension are more likely to be readmitted. Future studies are needed to further compare outcomes between non-ERP and ERP populations.

97

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064
1-310-437-0544
[email protected]
Monday - Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons