Half-day case robotic radical prostatectomy. Surgery of the future? A case report

Introduction. - Robotics and ambulatory are modern applications of surgery. This case study proves the feasibility of robot-assisted radical prostatectomy as an outpatient procedure. Method. - This report highlights the first, half-day, robotic prostatectomy performed on a 57 year-old man with localized prostate cancer. This operation was proposed to the subject because of his excellent physical condition and favorable environmental factors. He chose to undergo the surgery voluntarily. He underwent a nerve sparing radical prostatectomy. Target-controlled infusion propofol was used in perioperative sedation and analgesia. Postoperative evaluation criteria was made with the Visual Analog Scale of Pain Intensity (VASPI), Chung score and a patient satisfaction survey. Results. - No perioperative or postoperative complications were reported. Blood loss was low (75 mL). The patient stayed less than 12 hours in the ambulatory unit thanks to a rapid recovery. The patient returned home after reporting a Chung score of 10. No hospital readmission was necessary. Functional results were: a bowel movement on day 1, back to work on day 2, normal urinary continence on day 8, a correct erectile function on day 9. Oncological results revealed negative surgical margins for cancer and PSA postoperative <0.03 ng/mL. Conclusion. - Ambulatory robotic radical prostatectomies can be performed on voluntarily selected patients without affecting the high quality of urological surgery outcomes. (C) 2015 Elsevier Masson SAS. All rights reserved.