Same-Day Discharge Following Multiport Robot-Assisted Simple Prostatectomy: A Prospective Feasibility Study of Outcomes, Costs, and Post-Discharge Healthcare Utilization.

OBJECTIVE

To prospectively assess the feasibility, safety, and cost-effectiveness of a same-day discharge (SDD) pathway for multiport (MP) robot-assisted simple prostatectomy (RASP).

METHODS

Data from 48 consecutive patients undergoing MP-RASP between July 2021 and August 2025 were prospectively collected. All patients followed an Enhanced Recovery After Surgery protocol. We utilized a bladder neck-sparing technique with a transperitoneal approach and robotic transversus abdominis plane block. Healthcare utilization data consisted of postoperative calls/messages and unplanned visits. We also report average institutional costs for SDD versus inpatient RASP.

RESULTS

Forty of forty-eight (83%) patients were discharged same-day. Eight (17%) stayed overnight: 6 for patient preference and 2 for hematuria. Subsequent analyses included SDD patients only. The median operative time was 131 (115-147) minutes, and the median length of hospital stay was 141 (114-173) minutes with a median pain score at discharge of 3 (0-4). Two (5%) patients were readmitted within 30 days. During the first week, 4 (10%) patients visited the emergency room or clinic. Six (15%) patients contacted their care team on postoperative day 1 (3 for medication-related questions, 2 for catheter issues, and 1 regarding surgery). The direct cost per case was 33% lower for SDD RASP, with a greater revenue-to-cost ratio at 149% compared to 115%.

CONCLUSION

MP-RASP with SDD is safe and feasible, providing favorable outcomes with reduced hospital stay and lower costs.