Outpatient?

[ladylaura 77]

My surgeon says my surgery is going to be outpatient. Has anyone else had this? I keep reading people stay at least 24 hours, so I'm confused. I know he's a very well respected and advised surgeon in our area for this, and I know two people who had him too.

Is that something I should be concerned about though? I'm really nervous as it is...

[Molly3 495]

Hi LadyLaura,

I'll be an outpatient as well.....My surgery is June 7th!

[Sydney Susan 333]

Honestly, I'd change surgeons. This is a big op not a small one. I would change surgeons with even an overnight stay only.

There will be others who'll tell you they came through just fine, but I really question why a doctor would be pushing you out the door so quickly. My doctor was no dearer than anyone else in my area and his standard is 4 nights in hospital. I felt so well cared for, and he tells me he's never (yet) had a significant complication.

With a surgery like this you have a great risk of experiencing significant pain, becoming dehydrated and vomiting due to nausea. A drip for at least a couple of days will help with all of these, and allow you to take meds intravenously for nausea. You also need to have your "vital signs" and pain level monitored closely for a while and i don't think those will happen with early discharge.

It's also important to avoid vomiting with a newly sutured stomach... if you do it isn't necessarily a disaster, but it's a risk you don't want to take if you don't need to.

Pain or exhaustion that really reduces your mobility also poses the risk of blood clots forming, and heparin (anti clotting) injections are pretty standard for ops of this size, to protect you from this. Unless a medic visits you daily at home you won't get that.

I am not wanting to upset you but I'd rather that than stay silent and hear after how awful it was, or worse that something happened to you. I've read of no and one night stays on this forum before and it seems to me that many people really suffered for it. Why? It's just not necessary. It's of no benefit to you, so who is benefiting from such short, sharp treatment?

I am 100% sure I would not allow it for anyone I loved. You deserve better.

[leezel_777 2]

Hi Ladylaura,

Do you know if your surgeon performs outpatient surgery on all of his patients? I am scheduled to have my surgery as an outpatient on the 30th. I had to qualify to be able to have outpatient. I had to be under a certain BMI, not have sleep apnea, etc....basically be a lower-risk patient. If I didn't qualify, I would have spent a couple nights at a hospital. As an outpatient, I have been given my prescriptions of meds to take at home (anti-nausea, pain, and acid reducer) and I will have to return the following day for IV fluids to help prevent dehydration. But this is something I feel comfortable with...it sounds like you are a little unsure?

Maybe you could talk to your surgeon and see if that helps you feel more comfortable with the idea of outpatient surgery? If it doesn't, then maybe look for a surgeon who will let you stay at a hospital for a few days. I think you should do whatever makes you feel like you're getting the best care as possible. The surgery is going to be life changing and you want to be confident in the person who's performing it and providing your aftercare.

I hope this helps. Best of luck to you!

[MIJourney 490]

Mine was considered outpatient as was my gallbladder removal 20 years ago but I knew in both instances I would be staying overnight.

In the case of the sleeve I was told the room would be held for a 2 night stay and depending how I was doing I may be able to leave after 1 night. I was doing ok and chose to go home but could have stayed the 2nd night.

[mokee 588]

After the first night dr asked if I wanted to stay another night and I chose to stay. I was not getting out of bed too well and did not feel that I could handle all of my care at home. Is it being done in a outpatient facility? Or a hospital? My dr was a bariatric surgeon of excellence and so was the hospital. I had terrible pain that did not improve significantly for a week. But everyone is so different. You read about some going back to work in a week.

You still have time to research him. Best of luck.

[ladylaura 77]

Thanks everyone! He has his own clinic where he performs the surgeries (which is in the medical center of the hospital). He said there is a recovery area too if we wanted to use it. He is a well respected doctor, been on the news, many referrals, etc...so, maybe it's just being a low risk patient? I don't know. I will definately ask him next time. My insurance isn't covering any of this (bariatric surgery is excluded completely...stupid insurance), so I'm sure staying longer would be even more expensive. But, we will see...

It is nice to see there are others who do outpatient as well! I will keep everyone posted

[HatheryOnHerWay 603]

I'm currently on my way home from surgery, wgich I had outpatient on Wednesday. I had no more issues outpatient with this surgery than I did with my gallbladder removal. As far as questioning why the surgeon "wants you out the door so fast", my surgeon does it outpatient so it's more affordable for self-pay patients. Hospital costs are what really rack up for self-pay patients.

[Sydney Susan 333]

I can't argue with the cost issue - I think it is usual here for insurance to include lapband and VSG, but not everyone is insured, and then public hospital waiting times are long for things like this. A great many things in life are a trade off between cost and safety or cost and comfort, sadly.

I have previously asked my surgeon why he keeps his patients in hospital so long (although i was personally v pleased to have it done that way) and his reply was (in part) that Gastrectomy is done for lots of reasons, not just weight loss - cancer/tumours and ulcers on the fundus can lead to an op that is a lot like VSG. It is standard to keep patients for those ops in hospital for 3-10 days... And I have seen those same times quoted on US websites too.

He went on to say that many VSG patients have higher blood pressure, sleep apnea or other issues that put them in a higher risk category than the average person and he prefers more conservative treatment. And finally that it reduces the risk of complications and increases patient comfort. All very sound reasons to me.

Someone said earlier in this post that the OP should discuss with her dr and be sure she is comfortable with his reasons for discharging her on day 1... Specifically why he thinks this is right for her, not just "right"... And then the OP can decide what she needs to feel comfortable undergoing the op. I think that's good advice.

It's worth shopping around too, as longer days in hospital don't always mean greater cost - well where I live they don't.

Every clinic I spoke to charged the same "out of pocket " cost - Insurance companies in Australia can only insure up to 85% of of a govt determined cost for a particular service - the doctor can charge more (and most do) and the "gap" between the insurance payout and the cost gets bigger... and the patient has to pay.

Bariatric surgery is very competitive these days, and you too may find doctors are charging similar end costs to ensure their share of the market If you pay the same and get less care and follow up the doctor is pocketing the difference as profit. More care and follow up and he's investing in your health. It's always worth asking around.

[nervousnellie 50]

My doctor was going to send me home the same day as surgery. However, I asked to stay the night. For me, it was logistical. However, I was glad I stayed. Being on the pain drip significantly helped me be more comfortable. I don't think it's a terrible thing to have the surgery done outpatient. If you trust your surgeon, know that he has a great reputation and are comfortable with him, that's what matters. Best of Luck!

[inarakatra 51]

Did he say you weren't staying overnight? I've heard some say outpatient and still stayed at least one night.

[ladylaura 77]

He said I would go home the same day, but if I wanted to stay or if there were any issues, there was a place for me to stay. He has a really good rep and I've known 2 people who had him and both had good experiences. One of them had the surgery at night so he had to stay overnight. The other had other health issues going on too, so she had to stay to be monitored also. *Knock on wood* I am okay otherwise, so it looks like I can do the outpatient thing. It's good to see some of you did go home the same day and did okay

Did he say you weren't staying overnight? I've heard some say outpatient and still stayed at least one night.