Are morbidly obese patients suitable for ambulatory surgery?

PURPOSE OF REVIEW: The incidence of morbid obesity continues to increase worldwide. Associated comorbidities, particularly obstructive sleep apnea, increase the perioperative morbidity for this group of patients. The purpose of this review is to discuss appropriate selection of morbidly obese patients for ambulatory surgery.

RECENT FINDINGS: Patients with BMI <40 kg/m can safely undergo ambulatory surgery, provided their comorbidities are optimized before surgery. However, patients who are super obese (BMI ≥ 50 kg/m) have an increased risk of perioperative complications, suggesting that these patients should be selected with caution for ambulatory surgery. The outcomes data for patients with BMI between 40-50 kg/m are limited, and therefore, it is suggested that other factors such as obstructive sleep apnea are taken into consideration.

SUMMARY: Recent evidence suggests that carefully selected morbidly obese patients can safely undergo surgery on an ambulatory basis. Individualized evaluations taking into account patient-related factors, surgery-related factors, and anesthesia-related factors should dictate which patients are appropriate for ambulatory surgery.