April has been traditionally a slow month in my practice. Last year it was the only month that I did less than 12 robotic surgeries (I only did 9).
This year I performed 16 robotic surgeries in April.
12 of them were robotic prostatectomies for prostate cancer. The new things I have notice this year is that I have been getting the catheters out sooner more consistently. The last 85 patients have had their catheters removed after 1 week, with most of them removed after 5-6 days.
I have also stopped getting x-rays prior to catheter removal for routine cases.
The rate of discharge after 1 day has gone up as well. 39 of the last 40 patients went home the following day (the other 1 went home after 2 days). This is partly a factor of performing surgery on healthier people during the first few months of the year.
I also performed 2 robotic nephro-ureterectomies . This makes the total of 5 of these types of surgeries. The patients have done extremely well, especially since 4 of 5 of them were at least 80 years old. Most have gone home after 2-3 days and all have been able to go straight home without a nursing home stay.
I also performed 1 radical cystectomy. This patient was very difficult due to prior bladder surgery and I felt this operation was done safer with the robotic approach than the open approach. I have read studies out of Roswell Park (Buffalo) and University of North Carolina in the last 2 months that conclude that robotics will play an increasing role in bladder cancer surgery.