The following abstract was accepted for presentation at the International Robotic Urology Society meeting in Las Vegas for 2010.
Hospital Stay Beyond Two Nights for Robotic Assisted Laparoscopic Prostatectomy
Kusuma Kurmayagari MD, Naveen Kella MD
San Antonio, TX
In experienced hands, robotic assisted laparoscopic prostatectomy generally results in quick discharge home. Reasons for hospital stay beyond 2 days are examined from electronic hospital data from a single-surgeon series of 707 consecutive cases from April 2007 to September 2009 at a community-based institution. The surgeon had performed over 700 cases previously within a different system. A transperitoneal technique using the Montsouris approach was used. Criteria for discharge include pain control on oral medication, ability to ambulate and tolerate a regular diet and to be medically stable. Drains were removed prior to discharge in the vast majority, except in cases of increased drainage after a lymph node dissection. No open conversions were performed. 72% of patients were discharged after one night in the hospital. 21% were discharged after two nights in the hospital. The most common diagnosis for stay beyond two nights was ileus in 10 of the 34 patients (1.4%). The second most common reason was nonmedical in 7 of 34 patients. Post operative anemia requiring blood transfusion occurred in 4 patients (0.5%). Heavy drainage due to a urinoma was noted in one patient who was discharged drain free after 4 nights. The longest hospitalization was for 28 days due to unrecognized bowel perforation during adhesolysis. This was the only patient requiring a return to the operating room. No thromboembolic events or deaths were noted. Robotic prostatectomy can be a procedure with acceptable complication rates during the post-operative period, making the procedure suitable for an community-based practice.
