Trifecta of Same-Day Discharge after Single-Port Robotic-Assisted Simple Prostatectomy

Abstract

Introduction: There are numerous options available for the surgical treatment of benign prostate hyperplasia, and single-port robotic-assisted simple prostatectomy (SP-RASP) has emerged as a novel method in this field. In this study, we aim to define the trifecta of same-day discharge (SDD) and identify the factors associated with the trifecta of SDD following SP-RASP. Materials and Methods: Data from 95 patients who underwent SP-RASP between February 2020 and July 2024 at a single center by a single surgeon were evaluated. The trifecta of SDD was defined as a patient being discharged on the same day without experiencing any 90-day postoperative complications and no readmissions. The factors associated with predicting the trifecta of SDD were investigated. Results: A total of 95 SP-RASP cases were successfully performed without the need for conversion to alternative approaches, and 54 patients (56.8%) were included in the trifecta of the SDD-achieved group. The reasons for failure included 23 patients (24.2%) requiring postoperative hospitalization from the recovery area, 24 patients (25.3%) experiencing postoperative complications, and 2 patients (2.1%) needing readmission within 90 days after discharge. There was a 0% incidence of major postoperative complications (≥Clavien–Dindo grade 3). When comparing the groups, trifecta-achieved patients showed lower estimated blood loss, smaller specimen weight, lower percentage of adenoma removed, and a reduced rate of opioid prescriptions at discharge ( p = 0.005, 0.033, 0.025, and 0.026, respectively). In the multivariate logistic regression analysis, specimen weight was the only factor significantly associated with trifecta following SP-RASP ( p = 0.018). Conclusion: In our cohort, 56% of patients were classified within the trifecta group, with no major postoperative complications observed following SP-RASP. Specimen weight was the only independent predictor of trifecta achievement in these patients.