Comparative safety of same-day discharge with remote monitoring after laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass: a systematic review and meta-analysis

Published Date: 13th May 2026

Publication Authors: Asaad. A, Kortobi. G

Background
Bariatric surgery, primarily Laparoscopic Sleeve Gastrectomy (LSG) and Laparoscopic Roux-en-Y Gastric Bypass (LRYGB), is an effective treatment for obesity. As healthcare demand increases, same-day discharge (SDD) supported by remote monitoring (RM) is being explored to optimize resources without compromising safety. This systematic review and meta-analysis aimed to evaluate the safety and clinical outcomes of SDD with RM for primary bariatric surgery.
Methods
Following PRISMA guidelines and PROSPERO registration (CRD420251124540), a comprehensive search was conducted across PubMed, Scopus, and Web of Science. Six observational studies involving 1,581 patients (LSG: 1,164; LRYGB: 417) met the inclusion criteria. Outcomes included pooled readmission and complication rates, analyzed using a generalized linear mixed model.
Results
The overall pooled readmission rate for the RM subgroup was 3.35% (95% CI [2.57; 4.36]). Subgroup analysis revealed a significantly lower readmission rate for LSG (2.66%) compared to LRYGB (5.28%; P = 0.012). Major complications (Clavien-Dindo Grade 3 or higher) were rare at 1.58% and comparable between procedures. Overall complication rates were 3.80%. Meta-regression indicated that surgery type was not a significant moderator for major or overall complications, suggesting that the higher LRYGB readmissions were largely driven by manageable functional issues like dehydration.
Conclusions
Both LSG and LRYGB appear to have a favorable safety profile in an outpatient setting with remote monitoring, with LSG demonstrating an advantage of significantly fewer readmissions in the early postoperative period.

Abosheisha, M.; Asaad, A.; Kortobi, G. et al. (2026). Comparative safety of same-day discharge with remote monitoring after laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass: a systematic review and meta-analysis. Journal of Gastrointestinal Surgery, p.102453. [Online]. Available at: https://doi.org/10.1016/j.gassur.2026.102453