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A Fast-Track Protocol Enables Same-day Discharge After Robotic Pyeloplasty and Unilateral or Bilateral Ureteral

Grant Albers1, Elizabeth R Lyden2, Claudia Berrondo3

  • 1College of Medicine, University of Nebraska, Omaha, NE 68198.

Urology
|June 9, 2025
PubMed

Insights

A fast-track approach for pediatric robotic surgeries like pyeloplasty and ureteral reimplantation is safe and feasible. This method increases same-day discharges without raising complication risks, showing promise for shorter hospital stays.

Area of Science:

  • Pediatric Urology
  • Minimally Invasive Surgery
  • Surgical Outcomes Research

Background:

  • Robotic surgery offers potential benefits for pediatric urological procedures.
  • Optimizing post-operative care pathways, such as length of stay (LOS), is crucial for patient management and resource utilization.
  • Fast-track protocols aim to expedite recovery and discharge after surgical interventions.

Purpose of the Study:

  • To assess the safety and feasibility of a fast-track protocol for pediatric robotic pyeloplasty and ureteral reimplantation.
  • To evaluate the impact of this protocol on post-operative length of stay (LOS).
  • To identify predictors of same-day discharge in this patient cohort.

Main Methods:

  • Retrospective review of pediatric patients (0-18 years) undergoing robotic pyeloplasty or ureteral reimplantation.
  • Comparison of a fast-track group (protocol implemented Jan 2022) with a standard post-operative care group.
  • Analysis of baseline characteristics, post-operative complications, and same-day discharge rates.

Main Results:

  • The fast-track group showed a significantly higher rate of same-day discharge (47.3% vs. 10%, P < .0001).
  • No significant differences were observed in complications, emergency department visits, or readmissions between the fast-track and standard care groups.
  • Being the first case of the day was the primary factor associated with same-day discharge; surgical type or laterality did not influence discharge timing.

Conclusions:

  • A fast-track approach is safe and feasible for pediatric robotic pyeloplasty and ureteral reimplantation.
  • This protocol can shorten post-operative LOS and increase same-day discharge likelihood.
  • This study is the first to examine same-day discharge after bilateral robotic ureteral reimplantation.
Abstract

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