Friday, July 13, 2007
This presentation is part of : Initiatives for the Chronically Ill
Patient outcomes following minimally invasive prostate surgery
Catherine Mary Reid, RN, BN, honours1, Mari Botti, RN, PhD2, Rosemary Watts, RN, PhD1, Libby Beale, RN3, and Helen Crowe, RN, BAppSci, GDip, Epi, Biostats, MNursSci4. (1) Centre for Clinical Nursing Research, Epworth Hospital/Deakin University, Richmond Victoria, Australia, (2) School of Nursing, Faculty of Health and Behavioural Science, Deakin University, Burwood, Australia, (3) Urology Department, Epworth Hospital, Richmond Victoria, Australia, (4) C/Professor A Costello Suite 8.6, Epworth Centre, Richmond Victoria, Australia
Learning Objective #1: be able to describe the daVinci Robot and its components.
Learning Objective #2: be able to discuss the implications and at least five patient outcome benefits of RARP for evidenced based practice

BACKGROUND: Minimally invasive robotic-assisted radical prostatectomy (RARP) is a new surgical technique used worldwide to minimise surgical trauma. It has many potential benefits including shorter length of stay, faster patient recovery, less postoperative pain and an earlier return to preoperative function. Little is known however, about the trajectory of recovery and patient outcomes for this patient cohort.   

AIMS: The overall aim was to map patient trajectory of recovery following RARP during two care transitions for a cohort of patients in Australia 2006.  The specific aims were to map the trajectory of pain intensity and quality, identify time to mobilisation, determine the incidence and trajectory of complications, and describe functional status and quality of life.   

METHODS: A prospective, descriptive, survey design was used to track patient recovery during two key transitions: acute (time in ward) and intermediate (7 days and 4 weeks) using the Urologic Surgery Patient Recovery Survey incorporating the Short Form 36, American Pain Society Patient Outcome Questionnaire, McGill-Melzack Pain Questionnaire and the Sexual Health Inventory for Men. 

RESULTS: Prospective data have been collected from 28 consecutive patients. Preoperatively all participants reported good health with few co-morbidities. The majority had a BMI over 25kg/m2. Mean duration of surgery was 204 (SD=15) minutes; length of stay was three (SD = 0.716) days. On day one the majority of patients had mobilised and pain was reported as mild to moderate in intensity. By week four most participants reported urinary continence and had returned to work.  
DISCUSSION: Findings suggest that RARP patients experience faster recovery than conventional prostatectomy surgery patients and provide the basis for the development of evidence based practice guidelines to optimise care for this patient cohort.