Rethinking the Need for Overnight Admission After Robotic-Assisted Laparoscopic Prostatectomy

J Robot Surg. 2020 Jun 29;1-3. doi: 10.1007/s11701-020-01115-1. Online ahead of print.

Abstract

Robotic-assisted laparoscopic prostatectomy (RALP) is the gold standard for the surgical management of localized prostate cancer (PCa). Multi-institutional series have demonstrated complications and readmissions in less than 5% of patients and most are now discharged within 24 h of surgery. Recently, several high-volume surgeons demonstrated the safety of same-day discharge (SDD) after RALP. The main benefits include lower costs and reduced exposure to nosocomial infections and hospital errors. The leading arguments for criticism include potential suboptimal postoperative care and the risk of missing a catastrophic event. In recent years, important advances have further strengthened the argument for SDD including more structured perioperative care, integration of single-port robotic systems, and new challenges presented by the coronavirus 2019 (COVID-19) pandemic. Here, we provide further evidence demonstrating the safety of SDD in a multi-institutional cohort of patients and review the main arguments supporting the expanded use of this approach.

Keywords: Prostate cancer; Radical prostatectomy; Robotic surgery; Same-day discharge.