LAUSR

OBJECTIVES To report a single centre's experience of the feasibility, safety and patient acceptability of same day discharge Robot-Assisted Laparoscopic Prostatectomy (RALP). SUBJECTS/PATIENTS AND METHODS Between June 2015 and December 2021, a total of 180 pre-selected consecutive patients underwent RALP with the intention to discharge on the same day as surgery. Cases were performed by two surgeons. An Enhanced Recovery After Surgery (ERAS) programme was utilised. The feasibility of same day discharge was analysed, along with the complication rate, oncological outcomes, and post-operative patient experience. RESULTS 169 of 180 (93.8%) patients were successfully discharged on the same day as surgery. Median age was 63 years (range 44-74 years). Median console time was 97 minutes (range 61-256 minutes) and median blood loss was 200 mls (range 20-800 mls). Resection specimen pathology results were: pT2 69.4%, pT3a 24.4% and pT3b 6.5%. 25.9% had Gleason Grade Group (GGG) 1 disease, 65.7% had GGG2-3 and 8.4% were GGG4-5. Positive surgical margins were present in 25 cases (14.7%), 18 (15.5%) of which occurred in pT2 cases, and 7 (13.4%) in pT3 cases. There were no early (<90 days) biochemical relapses (defined as PSA>0.2ng/ml). The 30-day readmission rate was 3%. 13 early (0-30 days) complications were observed, 5 of which were Clavien-Dindo grade ≥3, however none of these would have been avoided had the patient remained in hospital on the first post-operative night. 107 of 121 (88%) consecutive patients returned a satisfaction questionnaire, and 92% of responders stated they preferred recovery at home, with 94% stating they felt ready to go home. CONCLUSION RALP combined with an ERAS programme allows patients to be safely discharged home the same day of their surgery. This is a feasible option, well-liked by patients, with morbidity and oncological outcomes similar to non-day-case or 23 hour stay RALP.