Feasibility of outpatient robot assisted laparoscopic prostatectomy

You have accessJournal of UrologyCME1 Apr 2023MP67-20 FEASIBILITY OF OUTPATIENT ROBOT ASSISTED LAPAROSCOPIC PROSTATECTOMY Kyle Szymanski, Hunter Lacouture, Jonathan Zakrajsek, Riley Gillette, Katie Colborn, Paul Maroni, Austin Derosa, and Janet Kukreja Kyle SzymanskiKyle Szymanski More articles by this author , Hunter LacoutureHunter Lacouture More articles by this author , Jonathan ZakrajsekJonathan Zakrajsek More articles by this author , Riley GilletteRiley Gillette More articles by this author , Katie ColbornKatie Colborn More articles by this author , Paul MaroniPaul Maroni More articles by this author , Austin DerosaAustin Derosa More articles by this author , and Janet KukrejaJanet Kukreja More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003330.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Research demonstrates the benefits of robotic-assisted prostatectomies (RARP) in regard to blood loss and post-operative recovery, there is a paucity in the literature regarding RARP as an outpatient procedure. With minimal operating room capacity during COVID-19, advances in minimally invasive surgical techniques and a relatively healthy patient population, outpatient RARP may be feasible. The aim of our study was to demonstrate the safety and feasibility of RARP as a same day outpatient procedure. METHODS: A retrospective cohort study at a single institution was performed by four fellowship trained surgeons who routinely perform RARP. Patients were identified through billing records who underwent RARP between January 2019 and December 2021. Patients were divided into two cohorts, inpatient (one stay past midnight) and outpatient (defined as same day surgery with no stay past midnight). Individual surgeons admission necessity during COVID-19 limitations. We then extracted data using the electronic health record (EHR). The two groups were then compared using standard statistical methods for cohort studies. Statistical significance was defined as p<0.05. RESULTS: Over a two-year period, a total of 497 RARP were performed with 139 (28%) outpatient cases. There was no difference in baseline demographics between the cohorts. There was a statistically significant difference in estimated blood loss (142 vs 102 mLs, p≤0.001) and operative time (193 vs 180 mins, p=0.004) in the inpatient vs outpatient cohorts, respectively. There was no significant difference in cancer stage, prostate size, or node/margin positivity between cohorts. There was a higher rate of readmissions (5% vs 0%, p=0.007) and number of ED presentations (0.15 vs 0.05, p=0.019) in the inpatient group. There was no difference in complication rates between the groups. Importantly, there was no significant difference in burden on the clinical staff demonstrated by no difference in number of phone calls to clinic, number of EHR messages, or opioid prescriptions on discharge. CONCLUSIONS: Overall, our data suggests that in a well selected patient group, RARP can safely be performed as an outpatient procedure with no significant differences on clinic staff workload or oncologic outcomes. While there was no pre-defined “algorithm” to determine outpatient vs inpatient surgery, the similarity in demographics and pre-operative characteristics between the groups lends support to performing this procedure as an outpatient with inpatient admission being reserved for select patients. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e951 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kyle Szymanski More articles by this author Hunter Lacouture More articles by this author Jonathan Zakrajsek More articles by this author Riley Gillette More articles by this author Katie Colborn More articles by this author Paul Maroni More articles by this author Austin Derosa More articles by this author Janet Kukreja More articles by this author Expand All Advertisement PDF downloadLoading ...