Single-port robotic prostatectomy is associated with higher same-day discharge and reduced length of stay: a NSQIP analysis.

PURPOSE: Same-day discharge (SDD) after robotic prostatectomy is an increasingly common paradigm for carefully selected patients. The single-port (SP) platform is associated with reduced length of stay (LOS) compared with multiport (MP) in prior studies. We assessed the association of SP versus MP with SDD rates, LOS, and 30-day complications for radical and simple prostatectomies. METHODS: The 2022-2023 NSQIP database was queried for patients undergoing radical or simple prostatectomy. Multivariable negative binomial regression analysis identified predictors of LOS, while logistic regression analyses identified predictors of SDD and complications. RESULTS: 12,504 radical (12,337 MP, 167 SP) and 519 simple prostatectomies (492 MP, 27 SP) met inclusion criteria. SP was associated with significantly reduced LOS in both radical (IRR = 0.59 [0.49-0.72], p < 0.05) and simple prostatectomy (IRR = 0.65 [0.42-0.99], p < 0.05) compared with MP. Use of SP was additionally associated with increased SDD in radical prostatectomy (OR = 5.25 [3.68-7.48], p < 0.05), but not simple (OR = 2.86 [0.38-14.4], p = 0.2). There were no significant differences in 30-day complications between SP and MP for either radical or simple prostatectomies. CONCLUSION: In this NSQIP study, SP-radical prostatectomy was associated with markedly higher SDD rates and reduced LOS compared with MP, while SP-simple prostatectomy was associated with reduced LOS. Neither procedure showed significantly increased 30-day complications, though the study was not powered to detect small differences in adverse event rates. These findings support continued investigation into platform-specific versus practice-level contributions to SDD.