277 Post-Operative Complications in Patients Undergoing Laparoscopic Sleeve Gastrectomy. a Comparison Between Surgical Sites

Abstract Aim In 2024 bariatric surgery services in our trust were expanded to a surgical hub, a hospital with short-stay surgical beds, 24/7 anaesthetic and medical cover, but no critical care. Criteria for the surgical hub are BMI <45, gastric sleeves, no revisional surgeries, no significant pain issues and no post-operative critical care requirement. The aim of this study was to compare post-operative complications of patients operated on at the hub with those with BMI >45 operated on at the tertiary centre, with the aim of guiding future patient selection. Method Post-operative complications following laparoscopic sleeve gastrectomy were reviewed for 11 patients with BMI <45 at the surgical hub and compared with 16 patients with BMI >45 at the tertiary centre. Results There were no post-operative complications in the surgical hub patients. Three patients at the tertiary centre had planned HDU stays due to pre-existing medical co-morbidities. There was 1 unplanned HDU admission due to difficulty weaning from high flow nasal oxygen in recovery. One patient returned to theatre due to hypotension secondary to haemorrhage. This patient (BMI 39) had a planned HDU bed due to obstructive sleep apnoea but was subsequently admitted to ICU. Conclusions There is a low rate of post-operative complications in patients with BMI >45, without significant comorbidities, undergoing laparoscopic sleeve gastrectomy. With careful patient preselection, consideration could be given to increasing the BMI limit at the surgical hub, reducing waiting list times and freeing up surgical space at the tertiary centre.