Safety of robotic-assisted gynecologic surgery and early hospital discharge in elderly patients

Abstract Background A minimally invasive surgical approach has proven to decrease peri- and post-operative complications and shorten duration of hospital stay, however there is limited data evaluating the safety of robotic-assisted surgery and early hospital discharge in the elderly population. As age is a well-known, independent risk factor for peri-operative morbidity and gynecologists treat many elderly patients, this is an important area of study. Objective To evaluate discharge timing and surgical outcomes in elderly compared to younger patients undergoing robotic-assisted gynecologic surgery. Study Design Retrospective cohort study of all patients who underwent robotic-assisted gynecologic surgery at a high volume, single institution from January 2013 - May 2016. Demographic information, discharge timing, and peri- and post-operative outcomes were compared for patients > 65 years using univariate and multivariate analyses. Results There were 2,757 patients included, with 2,521 > 65 years. Median age of the younger group was 42 years while median age of the elderly group was 69 years. Elderly patients had higher body mass index (BMI, kg/m 2 ), (28 vs. 26, P 23 hours (13% vs. 3%, P > 65y). There were no differences between elderly and younger patients in overall post-operative complications, reoperations, intensive care unit admissions, emergency room visits, or hospital readmission within six weeks of surgery. Conclusions Despite having more pre-operative risk factors and more surgically complex procedures, elderly patients undergoing robotic-assisted gynecologic surgery had similar post-operative complication rates and almost half of elderly patients were safely discharged the day of surgery. Our data suggest that robotic-assisted gynecologic surgery and early hospital discharge are safe in elderly patients.