2022-RA-1645-ESGO Same day discharge protocol for gynaecological oncology robotic surgery: single institute experience of initial implementation. (20th October 2022)

• Record Type: Journal Article
• Authors: Floreskou, Alvin Michael; Myriokefalitaki, Eva; Sap, Katelijn; Souza, Natasha D; Sivalingam, Vanitha; Datta, Meghna; de Cruze, Bridget; Winter-Roach, Brett; Smith, Michael
• Is Part Of: International journal of gynecological cancer. Volume 32(2022)Supplement 2
• Page Start: A166
• Page End: A166
• Publication Date: 2022-10-20
• Subjects: Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1136/ijgc-2022-ESGO.357
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Introduction/Background: Same-day discharge (SDD) is safe following minimally invasive hysterectomy. The Christie is a high-volume tertiary Cancer centre offering robotic surgery on high-risk patients with a successful Enhanced Recovery programme. Our aim was to create a pathway for SDD acknowledging that only a small cohort of our patients would be eligible. We present the feasibility and safety of service development. Methodology: Prospective cohort study of all patients who underwent robotic surgery for the treatment of gynaecological cancer, in our centre since March 2022, following clinical approval of Enhanced recovery and SSD pathway. Results: Initial, seven patients that were eligible for SSD were prospectively monitored. Mean age was 59(range 50–67)years old. 85.7% had previous abdominal surgery and 28.6% had undergone treatment for a different cancer, in the past. Mean BMI was 37(range 27–47) and they all had performance status of 0 and ASA=2. None was diabetic as this was an exclusion criterion. 42.9% had well controlled hypertension and another 42.9% were ex-smokers. Pre-operative haemoglobin was 139 (range 126–150) g/l.All had operations in the morning session and discharged successfully by 6pm same day.All patients underwent robotic total hysterectomy with bilateral salpingo-oophorectomy, 57% had sentinel lymph nodes and 42.8% omentum biopsied. There were no intraoperative complications and estimated blood loss was 50 mls. There were no concerns reported on follow up phone call day 1 and 2 post op. There were no readmissions and none 30-day post-operative complication on follow up clinic review. Patients satisfaction assessed by clinical nurse specialists as part of holistic needs assessment was very positive. Conclusion: Initial implementation is successful; following a robust preoperative and perioperative care pathway, including appropriate patients' selection and preparation. Post operative support and follow up is paramount. This is supported by a well established gynaecological oncology robotic service.