Preliminary results of the implementation of robotic radical prostatectomy in a major ambulatory surgery regimen

Abstract

Objective: To report our initial experience with robotic radical prostatectomy as an outpatient procedure.

Material and methods: Retrospective analysis of patients who underwent RRP as MAS (Major Ambulatory Surgery) at our center between March 2021 and May 2022. We collected baseline patient characteristics, intraoperative outcomes and postoperative data (need for unplanned medical care and complications at one month after surgery). Oncologic characteristics at disease diagnosis (PSA, staging, ISUP, MRI) and postoperative pathologic outcomes were collected.

Results: We identified a total of 35 patients with an average age of 60,8 ± 6,88 years and a BMI of 27 ± 2,9 Kg/m². All patients had a low anesthetic risk and 25.71% had undergone previous abdominal surgery. The surgical time was 151,66 ± 42,15 min and the average blood loss was 301,2 ± 184,38 mL. Two patients (5.7%) were admitted for one night and 7 patients (20%) consulted the emergency department in the following month, of which 3 (8.57%) were readmitted. We recorded one intraoperative complication, seven mild postoperative complications (Clavien I-II) and one severe complication (Clavien IIIb). The severe complication occurred on the eighth postoperative day and was not related to the procedure being ambulatory.

Conclusion: The absence of serious complications in the immediate postoperative period supports RRP in MAS as a safe technique for selected patients.

Keywords: Ambulatory basis; Cirugía mayor ambulatoria; Cirugía sin ingreso; Major outpatient surgery; Outpatient surgery; Prostatectomía radical robótica; Robotic radical prostatectomy; Régimen ambulatorio.