Introduction: Recent research has demonstrated that same-day discharge (SDD) robotic-assisted radical prostatectomy (RARP) can be safely conducted with comparable outcomes. We aimed to evaluate perioperative outcomes using our center’s new SDD protocol for RARP.  To our knowledge, we are the first center in Canada to implement this protocol.

Methods: This study was conducted at a single center, where eligible patients were offered voluntary SDD. Any cases that were deemed technically difficult were excluded from the SDD cohort per the surgeon’s discretion. All patients initiated on the SDD pathway were included in the analysis. Descriptive statistics were calculated for each group. Differences between groups were evaluated using analysis of variance and multiple linear regression.

Results: Data were available for 82 patients, 41 (50.0%) patients on the SDD pathway and 41 (50.0%) on the inpatient pathway (IP-RARP). For patients in the SDD pathway, 26 (63.4%) were successfully discharged same-day (SDDD-RARP), while 15 (36.5%) failed SDD (SDDF-RARP). There were no significant differences between cohorts in regards to baseline demographics (Table 1).  Length of stay was shorter in the SDDS-RARP cohort (7.9 vs. 22.6 vs. 29.9 hours; p<0.0001). Five SDDS patients (19.2%), five SDDF patients (33.3%), and nine IP-RARP patients (22.0%) presented to the emergency department (p=0.4). There were no unscheduled office visits or hospital admissions in either SDD cohort, with two readmissions in the IP-RARP cohort (p=0.4). Multiple regression revealed that the only predictive factor for SDDS was case order, with the first case of the day resulting in the highest chance of successful discharge.

Conclusions: We demonstrated the feasibility and safety of implementing a SDD pathway in men undergoing RARP at a high-volume center. There were no significant differences in baseline characteristics, suggesting that same-day surgery can be offered to the majority of patients undergoing RARP.