Outpatient robotic prostatectomy
With the advantages of robotic surgery of less pain and less blood loss, I have always wondered what will be the end result of the operation in regards to patient recovery and operating room times.
Since the total operation time has routinely fallen to the 2 to 2 1/2 hour range I thought an outpatient prostatectomy was a safe alternative for a patient that didn't want to stay in the hospital overnight.
I believe the first hospital to perform the surgery as an outpatient was Detroit's Henry Ford, and it has also been accomplished at other centers, such as Ohio State by Dr. Patel.
My criteria for outpatient surgery include:
1) Excellent health with no significant medical problems.
2) Perfect surgery with little blood loss.
3) Smooth recovery without significant nausea.
4) Clear urine in the catheter.
5) First operation of the day, so there is adequate time to recover prior to going home.
5) Patient desire to go home the same day and avoid a stay in the hospital.
6) Family comfort with the decision.
I have the patient go to the hospital floor after surgery, and if he is able to walk around without much of a problem and can tolerate liquids, allow him the option of going home.
We sent our first patient home this week after a robotic prostatectomy.
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Comments
Sounds like a great idea! I wonder about post-op pain? Are you using any special protocols like the 3-day or 5-day On-Q Soaker Pain System? I know that Dr. Vip Patel at Ohio State was a big advocate of that system. Also, do you routinely put in a drain? If yes, do you send the patient home with the drain or take it out after a few hours? Maybe I'm conservative, but so far, even if the case goes perfectly, I like always putting in a drain and setting them up to leave the next morning after I take out the (dry) drain. Please let me know how your patients do. I'd be interested in starting. I'll mention it to the appropriate candidates. Maybe we can collaborate on this! Thanks!
Posted by: Jay Yew, M.D. | March 31, 2006 1:12 AM