MP55-05 OUTPATIENT ROBOTIC SURGERY IN PEDIATRIC UROLOGY IN a RURAL SETTING: ARE WE READY TO TAKE THE LEAP?

You have accessJournal of UrologyPediatrics IV (MP55)1 May 2024MP55-05 OUTPATIENT ROBOTIC SURGERY IN PEDIATRIC UROLOGY IN a RURAL SETTING: ARE WE READY TO TAKE THE LEAP? Ahmad Dahman, Osama Al-Omar, Amr Elbakry, and Ahmed Ali Ahmad DahmanAhmad Dahman , Osama Al-OmarOsama Al-Omar , Amr ElbakryAmr Elbakry , and Ahmed AliAhmed Ali View All Author Informationhttps://doi.org/10.1097/01.JU.0001008616.01808.0f.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Most pediatric urologic surgeries are routinely done as outpatient procedures. Despite the expanding use of robotics in the field of pediatric urology, the usual practice is to admit patients for observation post-operatively. This is especially so in rural settings. As the only center providing pediatric urology care in the rural state of West Virginia, our objective is to report our initial experience in exploring the safety and feasibility of outpatient robotic surgery in pediatric urology. METHODS: We retrospectively identified all children who underwent robotic-assisted urologic surgeries as outpatient procedures at a single center. Data were collected regarding patient age, gender, operative details and follow-up. We also collected information regarding 30-day complications, phone calls to the urology care team, unplanned clinic or ED visits, readmissions or reoperation. We started transitioning to outpatient robotic surgery in 2019 with select procedures. Since 2022, outpatient robotic surgery became the standard for all non-complex pediatric robotic surgeries. All our patients are managed with a zero-narcotic approach for outpatient pain management. Patients are generally discharged without Foley catheters except in the case of ureteral reimplantation with a history of severe voiding dysfunction. RESULTS: A total of 36 patients (20 males) were identified between 2019 and 2023. Median age at surgery was 66 (7-214) months. Surgical procedures included partial cystectomy for urachal anomalies in 3 patients, ureteral reimplantation in 11, pyeloplasty in 13, uretero-ureterostomy in 3, nephrectomy in 2, Bilateral orchiopexy in 1, Mitrofanoff in 1, and ureterolysis in 2. No intraoperative complications were reported, and all patients were discharged from post anesthesia care unit (PACU). Follow-up duration ranged from 1 to 22 months. Four (11%) patients presented to the emergency department (ED) within 30 days postoperatively (1 for fever, 2 for urinary retention, and 1 for port site erythema). The urology team received Phone calls from 8 (22%) patients, none of which resulted in unplanned clinic or ED visits. The reasons for phone calls included wound/dressing questions in 3, dysuria, fever, hematuria, pain, and a medication reaction in one each. No readmission or reoperation was required within 30 days of surgery. CONCLUSIONS: Our initial experience indicates the safety and feasibility of outpatient pediatric urologic surgeries, including in a rural setting. Further studies with a larger number of patients are needed to support this conclusion. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e917 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Ahmad Dahman More articles by this author Osama Al-Omar More articles by this author Amr Elbakry More articles by this author Ahmed Ali More articles by this author Expand All Advertisement PDF downloadLoading ...