Day-case laparoscopic nephrectomy: Feasibility and safety

Abstract

Purpose: The method of surgery and its recovery play an important part in a success of any surgery. Implementing a minimal invasive approach with enhanced recovery protocol permits Nephrectomy to be performed as a day-case (DC) procedure. Here we report our initial experience with laparoscopic nephrectomy (LN) as DC surgery with an aim to assess its feasibility and safety. Patients and methods: In this retrospective observational study, nine patients underwent DC LN performed by a single surgeon (NR). LN was performed in the standard way followed by enhanced recovery pathway of care for DC. We collected data regarding demographic information, medical co-morbidities, preoperative outcomes, complications and readmission rates. The data was analysed and evaluated. Results: There were four (44.4%) women and five (55.5%) men with a median age of 35 years (range 17–52 years). Eight (88.9%) patients had benign diseases associated with non-functioning kidneys and one (11.1%) patient had a renal tumour. All patients (100%) were successfully discharged the same day with no major complication (Clavien Dindo Grade > I). Readmission rates were 0%. Conclusion: In our small series, DC LN is feasible and safe with a belief that the results are easily reproducible. Increasing experience in laparoscopic surgery with implementation of enhanced recovery protocol may help to increase the success rate of LN as DC.