Enhanced Recovery after Robotic Urologic Surgery

Robotic urologic surgery, a minimally invasive approach to procedures like prostatectomies, nephrectomies and cystoprostatectomy, has revolutionised patient care by reducing the physical toll of surgery. By combining these procedures with Enhanced Recovery After Surgery (ERAS) protocols, patients can look forward for shorter hospital stays, and expedite recovery. This article explores how ERAS principles and protocols enhance recovery after robotic surgery, offering a comprehensive look at the benefits and care strategies it entails.

Understanding ERAS Protocols

ERAS protocols are evidence-based guidelines designed to standardise and optimise perioperative care. Originating in the late 1990s, these protocols focus on reducing surgical stress, maintaining postoperative physiological function, and expediting recovery. For robotic surgery in Singapore, ERAS protocols encompass preoperative, intraoperative, and postoperative phases, each with tailored strategies to support patient recovery. 

• Perioperative phase:

• Patient education: Providing comprehensive preoperative education to patients about their procedure, the expected recovery trajectory, and the role of ERAS protocols.
• Nutritional optimisation: Emphasising the importance of preoperative nutritional support to enhance immune function and expedite wound healing.
• Pain management: Implementing a variety of pain relief methods, such as preoperative medications, regional anaesthesia techniques, and non-opioid painkillers, to lower the amount of pain and opioid use after surgery.

• Intraoperative phase:

• Minimally invasive approach: Utilising robotic-assisted techniques to perform urologic procedures with precision and minimal tissue trauma. 
• Fluid management: Using goal-directed fluid therapy to maintain euvolemia (pertaining to the normal volume of fluids or blood in the body), and optimise tissue perfusion while avoiding fluid overload.
• Normothermia: Maintaining intraoperative normothermia through active warming techniques to reduce the risk of surgical site infections and promote faster recovery. 

• Postoperative phase:

• Early oral intake: Encouraging early resumption of oral intake to prevent dehydration and gastrointestinal dysfunction.
• Ambulation: Facilitating early ambulation and physical activity to prevent complications such as deep vein thrombosis and promote postoperative recovery.
• Enhanced pain control: Continuation of multimodal analgesia (pain relief techniques) postoperatively, along with cautious use of opioids, to minimise pain and opioid-related side effects.

Benefits of ERAS in Robotic Urologic Surgery

The implementation of ERAS protocols in robotic urologic surgery has demonstrated a number of benefits for patients, surgeons, and healthcare systems alike:

• Shorter hospital stays: Studies have shown that ERAS protocols significantly shorten hospital stays after robotic urologic procedures by optimising perioperative care and encouraging early recovery.
• Faster recovery and return to normal activities: Patients undergoing surgery within an ERAS pathway experience quicker recovery times, enabling them to resume their daily activities and return to work sooner.
• Reduced postoperative complications: ERAS protocols have been associated with lower rates of surgical site infections, urinary retention, and other postoperative complications, thereby improving patient safety and satisfaction.
• Enhanced patient experience: By focusing on patient-centred care and minimising the physical and psychological stress of surgery, ERAS protocols contribute to a more positive overall experience for patients undergoing robotic urologic procedures.

Explore ERAS Protocols Further with Assure Urology and Robotic Centre

Enhanced Recovery After Surgery (ERAS) protocols have indeed altered the landscape of robotic urologic surgery, offering patients a pathway to quicker recovery and an improved robotic surgery success rate. By integrating these evidence-based guidelines into practice, our urologists in Singapore and healthcare teams can optimise perioperative care, minimise complications, and enhance the overall patient experience.

If you or a loved one are considering robotic urologic surgery, we invite you to learn more about our services at Assure Urology and Robotic Centre. Contact our urology clinic in Singapore today to schedule a consultation and discover how we can support you on your journey to better health.