Isabella Laws
Isabella Laws, Georgina Lewis, Jaydip Raut
Gloucestershire Royal Hospitals, Gloucester, United Kingdom
Abstract
Introduction
According to the Getting It Right First Time 鈥楤est practice day case hysterectomy delivery guide鈥� 50 % of laparoscopic hysterectomies should be performed as day case procedure. When effective day case pathways are implemented, they can deliver equivalent or better patient experience and outcomes when compared to currently conventional inpatient pathways. It is predicted that if trusts across the country adopted day case hysterectomy that up to 22,00 NHS Bed Days could be saved each year. At Gloucestershire Royal Hospitals, a day case hysterectomy pathway has been introduced.
Methods
Retrospective audit of patient variables including comorbidities, BMI and ASA grade alongside unplanned admission and complication rates were analysed over a six-month period between September 2023 and February 2024. Patients have also been contacted for experiential feedback.
Results
In the patient cohort, 59% of patients were undergoing surgery for pre-cancerous conditions, 30% for primary cancer and the remaining 11% for benign disease or risk reduction surgery. Results were generally positive, demonstrating that 78% of patients selected for day case hysterectomy were successfully discharged on the same day. Only 11% of patients presented with surgery related complications within a 30-day period.
Conclusions
Day case hysterectomy at this district general hospital has not been associated with increased morbidity. Next steps will include formally developing a trust guideline to widen patient selection for the pathway and evaluation of other gynaecological laparoscopic procedures which may be suitable for same day discharge. Ongoing audit will monitor patient outcomes and experience.