Feasibility and clinical outcomes of same-day discharge after robot-assisted partial nephrectomy at an ambulatory surgery center

Robot-assisted partial nephrectomy (RAPN) enables the management of complex localized renal masses while preserving renal function. However, the adoption of institutionalized same-day discharge (SDD) pathways remains limited. Herein, we report the safety and feasibility of SDD RAPN at an ambulatory surgery center (ASC) at our institution. We performed a retrospective observational study of patients who underwent SDD RAPN at a freestanding ASC at our institution during 2022-2025. Patients were eligible for the SDD pathway if they had a good performance status (ECOG 0-1), localized renal masses amenable to partial resection, reliable post-discharge communication, and travel time < 2 h from their residence to the hospital. A total of 63 patients underwent 65 SDD RAPNs at our ASC during 2022-2025. Patients had a median age at surgery of 62 years (interquartile range 51-71 years), and most were male (73%), non-Hispanic (63%), White (70%), and overweight (54%). Most patients had an American Society of Anesthesiologists score of III (60%), were never-smokers (63%), and had clinical stage T1 disease (92%). Most procedures were for lesions of moderate complexity (46%). All surgical specimens revealed negative surgical margins (100%), with the most common histology being clear cell carcinoma (63%). Overall, 4/65 (6%) procedures led to any-grade Clavien-Dindo complications and 2/65 (3%) required readmissions. No deaths or local or distant recurrence were observed at a median follow-up of 1.1 years. Overall, we found that SDD is safe and feasible for appropriately selected patients undergoing RAPN, with promising perioperative outcomes and low morbidity rates.