Influence of Patient and Intraoperative Characteristics on Length of Hospital Stay After Robotic Hysterectomy

Objective: The aim of this research was to determine patient and intraoperative characteristics that may predict feasibility of same-day discharge after robotic hysterectomy. Materials and Methods: Patients undergoing robotic hysterectomy from October 2007 to April 2011 were included in the study. Patient demographics were retrospectively collected and analyzed, include: age (years), height (inches), weight (kg), body mass index (BMI, measured in kg/m(2)), procedure indication, number of previous abdominal procedures, and American Society of Anesthesiologists (ASA) physical classification system score. Procedure data were collected as well as transfusion status, postoperative length of hospital stay (LOS), procedure type, presence of abdominal adhesive disease, conversion to laparotomy, estimated blood loss (EBL), procedure duration, intraoperative complications, and short-term complications. Results: Patient age (p < 0.0001), malignant diagnosis (p < 0.001), transfusion (p = 0.001), EBL (p < 0.001), intraoperative complications (p = 0.038), ASA score (p < 0.001), procedure performed (p < 0.0001), and adhesive disease (p = 0.024) were significantly associated with LOS. Case time, surgeon, BMI, and number of previous abdominal surgeries were not associated with LOS. Conclusions: Patient and intraoperative characteristics can be used to predict the likelihood of successful same-day discharge after robotic-assisted hysterectomy. Same-day discharge after robotic-assisted laparoscopic hysterectomy should be regarded as an essential component of cost containment.