An open-label randomized clinical trial of gastric bypass surgery using the FundoRing method in a substitute inpatient medical center

Objective. To analyze the results of single-anastomosis gastric bypass surgery using the FundoRing method in obese patients with ASA 1—2 status in a substitutive inpatient setting compared to a 24-hour inpatient setting. Material and methods. A prospective, open-label, randomized clinical trial (RCT) was conducted at two private surgical centers serving as the clinical base for Astana Medical University in Astana, Kazakhstan. Between July 2024 and February 2025, 157 single-anastomosis gastric bypass procedures using the FundoRing method were performed; of these, 113 patients met the inclusion criteria. All patients in the RCT were randomized using identical sealed envelopes into two parallel groups. Group 1 included 57 patients who underwent surgery on a day surgery unit, while Group 2 included 56 patients who underwent surgery on a 24-hour inpatient unit. Results. The median follow-up was 6 months. There were no deaths or clinically significant complications in either group. There were no conversions from laparoscopic to open surgery. There were 54 women (94.7%) in Group 1 and 48 women (85.71%) in Group 2. The average age was 37±2.7 and 40±3.2 years in groups 1 and 2, respectively (p=0.7). Preoperative body mass index was 38.12±8.0 kg/m2 in group 1 and 40.95±9.0 kg/m2 in group 2 (p=0.62). Postoperative body mass index was 25.9±3.87 and 26.6±3.8 kg/m2, respectively (p=0.43). The duration of surgery in group 1 was 105±6.7 min, and in group 2, 96±8.7 min (p=0.7). The hospital stay was 1±0.09 days in group 1 and 3.84±0.5 days in group 2 (p=0.03). The patient’s hospital stay in Group 1 was 121.000±40.9 rubles compared to 183.000±55.2 rubles in Group 2 (p=0.02). Conclusion. The main outcomes of single-anastomosis gastric bypass using the FundoRing method in obese patients with ASA 1—2 status, operated on inpatient versus outpatient basis, were similar, with the exception of a shorter length of stay and lower overall hospital stay costs in the outpatient setting.