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6 6 O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E | M AY 2 0 1 4 patients who are without serious car- diac and pulmonary issues that increase risks of post-op issues. Outpatient LSG will improve access for many patients who can't undergo the life- changing surgery because of financial concerns. ASCs must have overnight 23- hour stay capabilities if they are going to perform these proce- dures. Although we've shown it can be done, more clinical guidelines are needed to determine which patients can undergo the procedure safely in the ASC setting. Until then, proceed with caution and work with surgical professionals who B A R I A T R I C S U R G E R Y We reviewed the first 250 laparoscopic sleeve gastrectomies performed in our facility and published the results in the journal Surgery for Obesity and Related Disease ( tinyurl.com/ks72ww9 ). The short- and long-term results were impressive. • Operative times. They averaged 60 minutes and decreased as more cases were performed: an average of 85 minutes for the first 25 cases and 48 minutes for the last 25 cases. Patients spent a little longer than 2 hours in recovery, on average. • Demographics. Patients averaged 47 years of age, had an average body mass index of 43 kg/m 2 (32 patients with BMIs greater than 50 kg/m 2 were considered super-obese) and had several documented attempts at unsuccessful weight loss. • Complications. Both our transfer and readmission rates were similar to what other research has shown in the outpatient setting. Only 9 patients (3.6%) required hospital admission within 30 days of surgery. Two of the 9 were admitted the day after surgery for bronchitis and bleeding at the abdominal wall that required 2-unit blood transfusions. Two required day-of-surgery transfers to the local hospital for hypoxemia related to sleep apnea. No patients died, and none of the procedures were con- verted to open procedures. • Results. Patients lost an average of 60% of excess weight at 1 year post-op and 63% at 2 years. A year after surgery, diabetes improved or was resolved in 97% of patients, hypertension improved (97%) or was resolved (59%) and hyperlipidemia improved (88%) or was resolved (48%). Additionally, 61% of patients said their sleep apnea remained resolved 1 year after sur- gery. — Peter Billing, MD RESEARCH REVIEW 250 Laparoscopic Sleeve Gastrectomies OSE_1405_part2_Layout 1 5/8/14 2:23 PM Page 66