Feasibility and safety of early discharge after robot-assisted uro-oncologic surgery using wearable telemonitoring

Early discharge after robot-assisted uro-oncologic surgery remains limited by concerns regarding patient safety and the timely detection of postoperative complications. Wearable telemonitoring may facilitate earlier discharge while maintaining clinical surveillance during recovery. In this multicenter prospective study, 86 patients undergoing robot-assisted radical prostatectomy, partial nephrectomy, or radical nephrectomy were allocated to a control group (C, n = 43) receiving standard postoperative care or a wearable group (W, n = 43) managed through an early-discharge telemonitoring protocol. Patients in group W were discharged 48 h earlier and monitored remotely using a wearable sensor-equipped shirt and smartphone application. The system continuously recorded respiratory rate, heart rate, body temperature, and single-lead electrocardiographic data, while blood pressure, oxygen saturation, and blood glucose values were entered manually. The primary endpoint was the feasibility and safety of early discharge. Secondary endpoints included length of stay (LoS), early unscheduled hospital access, postoperative complications, readmissions, and usability assessed using the Mobile Health App Usability Questionnaire (MAUQ). The telemonitoring protocol enabled a planned 48-hour earlier discharge while maintaining comparable postoperative outcomes (2.8 ± 0.4 vs. 4.7 ± 0.8 days, p < 0.001). Early unscheduled hospital access was significantly lower in group W than in group C (2.3% vs. 25.6%, p < 0.01). Minor postoperative complications (Clavien-Dindo grade < III) occurred in 7.0% and 11.6% of patients in groups W and C, respectively (p = 0.71), while no major complications (Clavien-Dindo grade ≥ III) were observed. The monitoring system generated 68 alerts, leading to teleconsultation and, when clinically indicated, in-person evaluation. Three patients were readmitted following critical alerts related to arrhythmias or hypertensive crises. Adherence to monitoring was high, and technical issues (16.3%) were resolved without data loss. The mean MAUQ score was 95.3 ± 11.4, indicating high user satisfaction. Early discharge supported by wearable telemonitoring appears feasible and safe in carefully selected patients undergoing robot-assisted uro-oncologic surgery. The approach was associated with fewer unscheduled postoperative hospital visits, high patient satisfaction, and effective remote surveillance during recovery. Larger randomized studies are warranted to confirm these findings and evaluate the long-term clinical and economic impact of telemonitoring-based recovery pathways.Keywords: Remote monitoring; Telemonitoring; Wearable devices; Telemedicine; Early discharge; Robot-assisted surgery; Urologic oncology; Postoperative care.