Single-port Robotic Surgery Allows Same-day Discharge in Majority of Cases

Abaza, Ronney; Murphy, Christopher; Bsatee, Aya; Brown, Devon; Martínez, Oscar

doi:10.1016/j.urology.2020.08.092

Cited by 51 publications

(28 citation statements)

References 21 publications

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“…The risk of bias in patient selection in 8 clinical trials (29)(30)(31)(32)(33)(34)(35)(36) was assessed using the Cochrane bias risk assessment tool.…”

Section: Results Of Quality Assessmentmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy and safety of single port robotic radical prostatectomy and multiport robotic radical prostatectomy: a systematic review and meta-analysis

Wei¹,

Ji²,

Zuo³

et al. 2021

Transl Androl Urol

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Background: The purpose of this study is to compare the clinical efficacy and safety of single port (SP) robot radical prostatectomy and multiport (MP) robot radical prostatectomy.Methods: Using the China National Knowledge database, EMBASE, Cochrane library, PubMed, and other databases to obtain relevant research, SP robot radical prostatectomy and MP robot radical prostatectomy were comprehensively evaluated. The software used to evaluate the impact of the results in the selected articles was Review Manager 5.2. Deviation analysis, forest plot analysis, and sensitivity analysis were carried out for the collected data.Results: A total of 8 related studies that met the criteria were finally included. The data showed that the operation time of MP in the control group was significantly longer than that in the SP group [mean difference (MD) =−13.29; 95% confidence interval (CI): (−17.35, −9.23); P<0.00001; I 2 =50%]. The duration of intensive care unit (ICU) stay for SP surgery was shorter than that for MP surgery [MD =−18.30; 95% CI: (−29.17, −7.42); P=0.0010; I 2 =94%]. The blood loss of SP surgery was less than that of MP surgery [MD =−15.54; 95% CI: (−28.37, −2.71); the total effective rate was 0.02; I 2 =0%]. There was no significant difference in the incidence of postoperative complications between SP and MP surgery [risk ratio (RR) =0.95; 95% CI: (0.55, 1.63); P=0.85; I 2 =0%]. At the same time, the sensitivity analysis and funnel plot showed that this study was robust and publication bias was limited.Discussion: Our results show that SP Robotic radical prostatectomy is superior to MP Robotic radical prostatectomy in terms of efficacy and safety. SP robot radical prostatectomy is worthy of wide promotion.

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“…The risk of bias in patient selection in 8 clinical trials (29)(30)(31)(32)(33)(34)(35)(36) was assessed using the Cochrane bias risk assessment tool.…”

Section: Results Of Quality Assessmentmentioning

confidence: 99%

“…In the further screening, 68 articles were excluded due to insufficient data, article types, and failure of research design. Finally, 8 papers were included in the analysis (29)(30)(31)(32)(33)(34)(35)(36). Figure 1 is a flowchart that reflects the identification, inclusion, and elimination of publications in the search process.…”

Section: Search Processmentioning

confidence: 99%

Efficacy and safety of single port robotic radical prostatectomy and multiport robotic radical prostatectomy: a systematic review and meta-analysis

Wei¹,

Ji²,

Zuo³

et al. 2021

Transl Androl Urol

View full text Add to dashboard Cite

show abstract

“…One study also reported that the same-day discharge SP-RARP was feasible. 29 We noted that studies which used ''hour'' as the unit for the same-day discharge (discharged <1 day) were more precise. Similarly, in the SP-RARP group, catheterization time was less compared to the MP-RARP group.…”

Section: Perioperative Outcomesmentioning

confidence: 97%

Perioperative and Oncologic Outcomes of Single-Port vs Multiport Robot-Assisted Radical Prostatectomy: A Meta-Analysis

Yang

et al. 2022

Journal of Endourology

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Purpose: Although single-port robot-assisted radical prostatectomy (SP-RARP) is considered a safe and feasible approach for radical prostatectomy, the comparative performance of the SP robot with earlier models, including da Vinci Xi or Si, is elusive. This systematic review summarizes the current evidence on SP-RARP and compares its perioperative, functional, and oncologic outcomes to multiport robot-assisted radical prostatectomy (MP-RARP). Methods: We performed a systematic search in PubMed, Embase, Web of Science, and Cochrane Library database for randomized control trials (RCTs) and non-RCTs that compare SP-RARP to MP-RARP. The primary outcomes included perioperative, functional, oncologic, and painful outcomes. The odds ratio (OR) and weighted mean difference (WMD) were applied for the comparison of dichotomous and continuous variables with 95% confidence intervals (CIs). Results: Seven studies, including 1239 patients, were enrolled in the meta-analysis. We reported similar results for SP-RARP and MP-RARP in terms of the operative time, blood loss, continence and potency rates, complication rate, positive surgical margin, and biochemical recurrence. However, hospital stay (WMD -17.86 hours, 95% CI -27.80 to -7.92; p = 0.0004), catheterization time (WMD -1.51 days, 95% CI -2.60 to -0.41; p = 0.007), and the rate of opioid use (OR 0.26, 95% CI 0.13 to 0.53; p = 0.0002) were less with SP-RARP. In addition, more patients did not require any pain medication during the hospital stay with SP-RARP (OR 14.41, 95% CI 5.22 to 39.76; p < 0.00001). Conclusions: SP-RARP is associated with a shorter hospital stay and catheterization time, and the need for postoperative pain medication is lower compared to MP-RARP, with comparable perioperative, functional, and oncologic outcomes.

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“…Advancements in minimally invasive surgery (MIS) techniques have resulted in a growing trend for same-day discharge (SDD) following complex surgical procedures. 5,6 This shift in surgical care has provided an alternative to safely provide elective procedures while reducing the incidences and lengths of inpatient hospital stays, thereby increasing patient safety, especially in the midst of a pandemic. 5 Current literature suggests that SDD for apical POP repair, regardless of previous pelvic surgery or nulliparity, is safe and feasible with no increase in the number of unplanned provider contacts, including clinic visits, emergency room visits and hospital readmissions.…”

Section: Copsmentioning

confidence: 99%

Patient Perspectives toward Undergoing Same-Day Discharge for Apical Pelvic Organ Prolapse Repair Surgery during the COVID-19 Pandemic

et al. 2022

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Introduction:To ensure patient satisfaction during the COVID-19 pandemic, hospitals implemented changes to elective surgeries while upholding safety and quality of care. This includes a growing trend toward same-day discharge (SDD) following apical pelvic organ prolapse (POP) repair surgery, which previously involved overnight hospitalization for some institutions. We assessed patient perspectives following SDD after transvaginal and minimally invasive apical POP repair during the pandemic.Methods:This was a cross-sectional study of women who underwent apical POP surgery. Preoperatively, we assessed preference for SDD. A postoperative survey evaluated perceived safety, pain control and satisfaction using the “Core questionnaire for the assessment of Patient Satisfaction for general Day-care” and the “Patient Global Impression of Improvement.” Postoperative complications were identified.Results:Of 36 recruited patients, 83.3% preferred SDD preoperatively. When rating the influence of COVID-19 on their preference (1–10, 10=high), 13 reported level 10 and 11 reported level 1 (mean 5.9±4.0). A total of 34 postoperative surveys were collected, 29 of which were SDD (85.3%); 89.7% of patients reported feeling safer with SDD, and 40% (2/5) of admitted patients would have preferred SDD. Pain control satisfaction for SDD was assessed on a Likert scale (1–10, 10=very satisfied), with a mean of 9.1 (±1.8); 82.8% of SDD patients rated their overall experience as “very satisfied” and consistently rated individual components highly.Conclusions:During the pandemic, our patient population preferred SDD after an apical POP repair with a high success and satisfaction rate with minimal complications. In the absence of a pandemic, SDD should be considered to increase patient satisfaction.

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Single-port Robotic Surgery Allows Same-day Discharge in Majority of Cases

Cited by 51 publications

References 21 publications

Efficacy and safety of single port robotic radical prostatectomy and multiport robotic radical prostatectomy: a systematic review and meta-analysis

Efficacy and safety of single port robotic radical prostatectomy and multiport robotic radical prostatectomy: a systematic review and meta-analysis

Perioperative and Oncologic Outcomes of Single-Port vs Multiport Robot-Assisted Radical Prostatectomy: A Meta-Analysis

Patient Perspectives toward Undergoing Same-Day Discharge for Apical Pelvic Organ Prolapse Repair Surgery during the COVID-19 Pandemic

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