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Background: Advancement in surgery has shifted numerous procedures to a same-day discharge (SDD) setting. In this study, we evaluated factors related to SDD after robotic transversus abdominis release (rTAR). Materials and Methods: A retrospective analysis of a prospectively maintained hernia databank was performed. Patients who underwent rTAR for incisional hernias were assigned to either the SDD group (length of stay [LOS] <1) or the inpatient group (LOS ≥1 day). Pre-, intra-, and postoperative variables were compared. Predictors of SDD were explored through a logistic regression, and a mediation analysis was performed to assess their effect on the LOS. Results: Out of the 167 patients included, 53 patients were discharged the same day. Age, American Society of Anesthesiologists score, history of coronary artery disease, and wound infection were significantly higher in the inpatient group. Overall, median LOS was 1 (0-2). Postoperative complications did not differ between SDD and inpatient groups except for Clavien-Dindo Grade-II (1 versus 14, respectively; P = .039). Thirty-day readmission rates were comparable (P = .229). A binary logistic regression to predict factors associated with SDD rTAR showed statistical significance in age, operative time, mesh area, and history of wound infection. Mediation analysis showed that mesh size indirectly affected the LOS through the operative time (a = 0.54; b = 0.46; P < .001). An age >46-year-old, an operative time beyond 217 minutes, and a mesh size >475 cm2 increased the probability of an inpatient stay (area-under-the-receiver operating characteristic curves: 0.69, 0.81, and 0.82, respectively). Conclusion: The pre- and intraoperative factors associated with SDD rTAR were age, history of wound infection, operative time, and mesh area. Further studies are needed to investigate the appropriateness of discharge decisions while balancing patients' benefits, resource utilization, and costs. [ABSTRACT FROM AUTHOR]

Imaging studies suggested that the RFB had been present for a few days causing an obstruction; there were no signs of bowel perforation. Rectal foreign body (RFB) insertion is a rare referral to the surgeon on call. Nonsurgical removal of the RFB in the ED, with the patient under conscious sedation, failed. [Extracted from the article]

Perforated diverticulitis remains a challenging emergency, with its management widely debated. Although a laparoscopic approach reduces the risk of both procedures, studies showed that sigmoidectomy with primary anastomosis in perforated diverticulitis is preferable to a Hartmann's [3,4]. Robotic natural orifice intracorporeal anastomosis and extraction sigmoidectomy for Hinchey Class IV diverticulitis - A video vignette. [Extracted from the article]

2021; 35 (6): 3205 - 13. https://doi.org/10.1007/s00464-021-08350-z 3 Kudsi OY, Gokcal F, Bou-Ayash N, Chudner A. Robotic sigmoidectomy for diverticulitis - natural orifice extraction with stapleless hand-sewn intracorporeal anastomosis. The COVID pandemic affected hospital bed occupancy and surgeons are optimizing treatments to allow same-day discharge for elective cases such as sigmoidectomy for uncomplicated diverticulitis. Refractory recurrent uncomplicated diverticulitis is managed surgically [1]. [Extracted from the article]

Association of Timing of colostomy reversal with outcomes following Hartmann procedure for diverticulitis. Staged robotic colostomy reversal and Botox followed by hybrid TAR - A video vignette Parastomal hernia is an independent risk factor for incisional hernia in patients with end colostomy. [Extracted from the article]