The patient, who underwent robotic surgery, returned home the same day of the intervention.
This case is the starting point of a program that hopes to include around 40 patients annually.
On March 9, the Urology Service of the Bellvitge University Hospital (HUB) performed for the first time in Spain a radical prostatectomy (total removal of the prostate) under a major outpatient surgery regime. This means that the patient, who underwent robotic surgery, returned home the same day of the intervention, without having to spend one or two nights admitted to the hospital, as has been the norm so far in this surgery.
For the patient, prostatectomy in a major outpatient surgery regimen has the advantages of a reduction in the risk of complications of hospital admission, and greater comfort and well-being, since the surgical intervention interferes less in their daily life and allows them to return earlier to their usual activities. In order to safely perform this type of surgery on an outpatient basis, it is necessary for the surgical team to have extensive experience in the technique.
The Urology Service of the Hospital de Bellvitge is one of the centers in Spain that performs more prostate surgeries annually. In addition, since 2009 he began to perform radical prostatectomies using a surgical robot, an already well-established system in which the surgeon controls the articulated arms of the robot from a console with three-dimensional vision that allows millimeter precision in movements. Currently, the Hospital de Bellvitge already performs all radical prostatectomies through robotic surgery.
This first case is the starting point of an outpatient radical prostatectomy program at the Bellvitge Hospital, in which it is expected to be able to include about 40 patients annually (35% of the total). To put it into operation, a multidisciplinary action protocol has been established in which specialists in urological surgery, anesthesiology, operating room nursing and major outpatient surgery nursing participate, under the coordination of the Functional Unit for Prostate Cancer of the HUB and the ICO (which includes surgeons, medical oncologists, radiation oncologists and specialized prostate nurses).
The patients will be selected based on a set of criteria, among which those of not having significant comorbidities, the anticipation of a slightly complex intervention, and the set of usual criteria for patients with major outpatient surgery. Likewise, they need to be accepting and motivated patients to participate in this program. Radical prostatectomy is one of the most common cancer surgeries. It is one of the usual options for the treatment of prostate cancer, of which 5,000 new cases are diagnosed each year in Catalonia. Patient survival is greater than 90% at five years. In 2019, the Bellvitge University Hospital performed 115 radical prostatectomies, all of them with robotic surgery.
Since 2009, he has performed more than a thousand of these interventions using robotic surgery. Dr. Francesc Vigués, head of the Urology Service of the Bellvitge University Hospital, emphasizes that the outpatient technique “does not differ from the usual, except for some modifications in the preoperative period and some adjustments in analgesia; really, the key to be able to start the program with all the guarantees is the experience of the team ”.
In the same vein, Dr. José Francisco Suárez Novo, coordinator of the Prostate Cancer Functional Unit of the HUB and the ICO, emphasizes that this new pioneering program “would not have been possible without the strong involvement of the professionals who collaborate from the different specialties; although last year it was not possible for us to start it due to the pandemic, we want this same 2021 to be a consolidated reality in our hospital ”. Until now, outpatient radical prostatectomy has been performed primarily in hospitals in France and the United States that also have extensive experience in robotic surgery.