# Outcomes of a newly established bariatric program in a hospital without an intensive care unit: a retrospective analysis of safety and effectiveness

## TL;DR

A new bariatric surgery program at a hospital without an ICU achieved safe and effective outcomes through proper planning and training.

## Contribution

Demonstrates successful implementation of a bariatric program in a hospital without an ICU, achieving low complication rates and significant weight loss.

## Key findings

- 93.1% of patients had no complications, with serious complications dropping from 7.69% in 2021 to 0.97% in 2024.
- Mean total weight loss was 29.61% for gastric bypass and 25.92% for sleeve gastrectomy.
- High comorbidity resolution rates were observed for diabetes, hypertension, and metabolic syndrome.

## Abstract

Bariatric surgery effectively contributes to substantial weight loss and improvement of obesity‑related comorbidities. Establishing new bariatric programs, particularly in hospitals without intensive care units, requires tailored implementation strategies and careful resource planning to ensure both safety and efficacy.

The aim of this study was to retrospectively assess the safety and efficacy outcomes of a newly implemented bariatric program the Military Institute of Aviation Medicine.

This retrospective study evaluated all bariatric surgeries (n = 267) performed between September 2021 and December 2024 at our hospital following the establishment of a comprehensive bariatric program. The program included surgeon training, multidisciplinary team formation, protocol development, and infrastructure modifications. Patient demographics, operative details, complications, weight loss outcomes, and resolution of comorbidities were analyzed.

Laparoscopic sleeve gastrectomy (LSG) was the predominant procedure (85.77%), followed by laparoscopic Roux‑en‑Y gastric bypass (LRYGB, 13.86%). Mean (SD) operative time was 145 (35) minutes for LRYGB and 77 (19) minutes for LSG. Overall, 93.1% of the patients had no complications, with the rate of serious complications requiring surgical intervention (Clavien–Dindo grade IIIB) decreasing from 7.69% in 2021 to 0.97% in 2024. No mortalities occurred. Among the 112 patients (68.3%) with available follow‑up data, mean (SD) percentage of total weight loss was 29.61% (12.08%) for LRYGB and 25.92% (10.57%) for LSG. High rates of comorbidity resolution were observed for type 2 diabetes mellitus (90.91%), hypertension (65.79%), dyslipidemia (70%), and metabolic syndrome (91.67%).

With careful planning, comprehensive team training, and adherence to established protocols, a new bariatric surgery program can achieve excellent safety and effectiveness outcomes from inception. The results validate our approach to program development and patient care.