Outcomes and Safety of Same-Day Discharge Following Minimally Invasive Abdominal Surgery: A Systematic Review.

Abstract

Same-day discharge (SDD) following minimally invasive abdominal surgery has emerged as a paradigm shift in perioperative care, aiming to enhance patient comfort and optimize healthcare efficiency. This systematic review evaluates the safety and outcomes of SDD after minimally invasive abdominal procedures. A comprehensive literature search was conducted using PubMed, Google Scholar, and the Cochrane Library for studies published between January 2015 and December 2025. The quality of randomized controlled trials and non-randomized studies was assessed using the Cochrane Risk of Bias 2.0 tool and the ROBINS-I tool, respectively, with visual summaries generated using RobVis. A total of 12 studies were included, covering procedures such as colectomy, hysterectomy, bariatric surgery, appendectomy, and cholecystectomy. The primary outcomes assessed were 30-day readmission, postoperative complications, reoperations, mortality, and ED visits. The findings indicate that, with appropriate patient selection, structured discharge planning, and adequate follow-up, SDD is a safe and effective approach. Reported readmission rates ranged from 3% to 7%, while major complication rates were low (0.9-5%). Thirty-day mortality was rare, ranging from 0% to 1% across the included studies. Post-discharge challenges such as pain, nausea, and wound complications highlight the necessity of a structured Enhanced Recovery After Surgery-based perioperative care pathway that extends beyond discharge planning to encompass all aspects of patient management. Overall, SDD appears to be a safe and feasible strategy for carefully selected patients undergoing minimally invasive abdominal surgery without increasing the risk of adverse outcomes. Successful implementation depends on strict patient selection criteria, effective perioperative planning, and robust post-discharge follow-up systems.