Study of the feasibility of outpatient sacrocolpopexy by laparoscopy

Minimally invasive surgery has become indispensable, allowing an improvement in postoperative follow-up with a reduction in postoperative pain, operative morbidity (in particular blood loss), the risk of infections at the operative site, a quicker recovery, and a much shorter hospitalization period [1,2]. Subsequently, the concept of outpatient surgery was developed with a real contribution to the quality of life of patients. Its main benefit is a reduction in infections associated with care [3]. Owing to a faster return to a familiar environment, high rates of patient satisfaction after outpatient procedures were reported [4], [5], [6]. In addition, the costs incurred to the hospital are lower than those for conventional surgery [7,8]. Early discharge does not increase the rate of postoperative complications, which are solely related to the surgical procedure and not to the type of postoperative management or rates of emergency consultation and rehospitalization [9].

Laparoscopic sacrocolpopexy (LSCP) is currently the recommended surgical technique for pelvic prolapse [10], [11], [12]. LSCP is usually managed with a standard hospitalization in France; the average hospital stay reported with the main code used for LSCP (JKDC0010) was approximately 2 days in 2021, with an outpatient rate of 675/8223 (8 %) [13]. Recent studies have suggested that ambulatory management is feasible for treating pelvic prolapse [13], [14], [15], [16], [17], [18], [19].

We hypothesized that LSCP, a relatively painless procedure, could be performed. The main objective of our study was to evaluate the rate of rehospitalization between ambulatory discharge after LSCP and the postoperative follow-up visit (Day 45). The second objective was the feasibility of discharge at eight hours after the end of the procedure (H8) after LSCP. Postoperative complications and quality of life were also evaluated.

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