Category: Laparoscopic/ Robotic: Prostate

MP15-3 - Safety and Feasibility of Outpatient Robotic Assisted Radical Prostatectomy in a Managed Healthcare Setting

Sat, Sep 22
10:00 AM - 12:00 PM

Introduction & Objective :

Since its inception, RARP has developed into a familiar surgical modality with improved perioperative outcomes including decreased hospital stay for prostate cancer patients. Experience with outpatient Robotic Assisted Radical Prostatectomy (RARP) has been reported as early as 2010. In this study, we evaluate the safety and feasibility of outpatient RARP by comparing perioperative outcomes between patients undergoing outpatient RARP to patients discharged on the day following RARP.


Methods :

This is a single institution retrospective cohort study. Patients without severe systemic disease who underwent RARP without pelvic lymph node dissection from September 2017 to January 2018 for localized prostate cancer were included. T-tests and chi-squared analysis were used to compare demographic and perioperative characteristics of patients who were discharged on the same day of surgery (outpatient RARP) to patients discharged on the day after surgery (inpatient RARP).


Results :

Of the 51 patients included in the study, 26 underwent outpatient RARP while 25 underwent inpatient RARP. There was no significant difference in age (61.4 vs 65.8 years, p=0.05), BMI (27.1 vs 28.3kg/m2, p=0.35), tobacco use (8 vs 15%, p=0.41), PSA (8.7 vs 8.4ng/dL, p=0.77), biopsy Gleason score distribution, prostate size (51.8 vs 57.7cc, p=0.26) or preoperative hemoglobin (14.3 vs 13.4g/dL, p=0.06), respectively. There was no difference between operative time (95.3 vs 101 minutes, p=0.16), EBL (52.8 vs 66.5cc, p=0.08), post-operative change in hemoglobin (-1 vs -1.1g/dL, p=0.62), pathologic stage distribution or complication rate (4 vs 8%, p=0.58) between patients who underwent outpatient vs inpatient RARP, respectively.


Conclusions :

Outpatient RARP offers similar or improved peri-operative outcomes when compared to inpatient RALP. We advocate outpatient RARP as a safe and feasible alternative to inpatient RARP for appropriately selected patients with localized prostate cancer.  

Peter Elliott

Resident Physician
Kaiser Permanente Los Angeles Medical Center
Los Angeles, California

Peter A. Elliott, MD
PGY 6, Urology
Kaiser Permanente, Los Angeles Medical Center

Pooya Banapour

Resident Physician
Kaiser Permanente Los Angeles Medical Center
Los Angeles, California

Ashish Parekh

Interim Chief of Urology, Kaiser Permanente Bakersfield
Kaiser West Los Angeles Hospital
Los Angeles, California

Apurba Pathak

Attending Urologist
Kaiser West Los Angeles Hospital
Los Angeles, California

Madhur Merchant

Attending Urologist
Kaiser West Los Angeles Hospital
Los Angeles, California

Kirk Tamaddon

Chief of Urology
Kaiser West Los Angeles Hospital
Los Angeles, California