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research. "The rea-
son we were doing
it is because so
many people looked
so good the morning
after surgery that
there didn't seem to
be a real need for
them to stay in the
hospital," he says.
The facility's proto-
col was to limit the
same-day option to
only the first case of
the day; all other
cases had to stay
overnight.
Dr. Castle notes a
few barriers to get-
ting wider accept-
ance of same-day
RARP:
• Getting patients and their families comfortable with the concept.
"A patient who would feel more comfortable being in the hospital
would not be a good candidate," he says.
• The surgical and post-operative care teams must also buy into the
concept. "They have to be primed for it," says Dr. Castle.
• Medicare requires a full hospital admission to reimburse for the
procedure. That meant after recovery, patients went onto the floor,
where a nurse had to admit them — a process that takes an hour or
U R O L O G Y
BELIEVER Robert Reiter,
MD, of the UCLA Prostate
Cancer Treatment and
Research Center, is one
of the few surgeons who
performs same-day roboti-
cally assisted radical
prostatectomy.
