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. 2021 Jan;47(1):30-34.
doi: 10.5152/tud.2020.20414. Epub 2020 Oct 30.

Day-case robot-assisted laparoscopic surgery: Feasibility and safety

Narasimhan Ragavan  1 , Sandeep Bafna  1 , Mathisekaran Thangarasu  1 , Sanjay Prakash  1 , Rajesh Paul  1 , Pradeep Chirravur  2 , Srivathsan Ramani  3
Affiliations

Day-case robot-assisted laparoscopic surgery: Feasibility and safety

Narasimhan Ragavan et al. Turk J Urol. 2021 Jan.

Abstract

Objective: The delivery of surgical services has undergone a shift in the past decade with increasing numbers of surgeries being performed in the daycare setting. Implementing a minimally invasive surgical approach with a robot with an enhanced recovery protocol permits robot-assisted laparoscopic surgeries (RALS) to be performed as a day-case (DC) procedure. This study aimed to assess the feasibility and safety of DC surgery according to our experience.

Material and methods: In this prospective observational study, 43 patients underwent DC RALS performed by a single surgeon over 18 months [simple nephrectomy (n=7), radical nephrectomy (n=15), radical nephrectomy with para-aortic lymphadenectomy (n=5), and adrenalectomy (n=5)]. In addition, reconstructive urological procedures that included pyeloplasty (n=9), ureteroureterostomy (n=1), and bladder diverticulectomy with ureteric re-implantation (n=1) were performed as DC surgeries during this study period. RALS was performed in the standard way with an enhanced recovery pathway of care for DC. We collected data regarding the demographic information, medical comorbidities, preoperative outcomes, intraoperative outcomes, complications, length of stay, and readmission rates. The data were analyzed and evaluated.

Results: All the patients (100%) were successfully discharged on the same day with no major complications (Clavien-Dindo grade>I). The readmission rates were 0%.

Conclusion: DC RALS are safe and feasible with an enhanced recovery protocol. With adequate protocols in place, these surgeries might prove to be better than the available minimally invasive techniques and can become the standard of care in the future.

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Conflict of interest statement

Conflict of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Proposal plan for day case robotic-assisted laparoscopic procedure
See this image and copyright information in PMC

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