Abstract
The authors report on narcotic avoidance following robotic assisted laparoscopic radical cystectomy allowing for a routine 2 day postoperative hospital course. This is a single surgeon experience of 54 patients over 5 years. However, there is much more to their success in early discharge aside from just limiting narcotic usage. Routine use of alvimopan (once approved by the FDA) was administered starting in the preoperative period and continuously until bowel function returned. Additionally, a subcutaneous pump for long acting local anesthetic administration was used for up to 3 days at the time of surgery.
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