This is a prospective cohort study of outcomes of patients undergoing outpatient colorectal surgery at a single institution to study outpatient colectomy as a viable treatment option for a select group of patients requiring colon and rectal surgery.
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Eligibility Criteria
Inclusion Criteria:
* Ages 18-70
* Undergoing robotic-assisted right colectomy, sigmoidectomy, or low anterior resection.
* Able to perform greater than 4 metabolic equivalents (METS) without shortness of breath
* Must have a designated adult who can care for them at home postoperatively until thei…
Inclusion Criteria:
* Ages 18-70
* Undergoing robotic-assisted right colectomy, sigmoidectomy, or low anterior resection.
* Able to perform greater than 4 metabolic equivalents (METS) without shortness of breath
* Must have a designated adult who can care for them at home postoperatively until their in-person clinic visit
* Access to a cell phone or computer and running water.
* Successfully completed pre-operative and post-operative education
* Medical criteria:
* Well controlled hypertension with systolic blood pressure \< 140 controlled by less than two medications which they are compliant with
* Well controlled diabetes on oral agents only with blood glucose level \< 180 on daily checks
* Anti-platelet agents including aspirin, clopidogrel, prasugrel, ticagrelor or ticlopidine will be stopped 7 days preoperatively and restarted on postoperative day 1. See exclusion criteria 7 for specific exclusion criteria regarding antiplatelet agents.
Exclusion Criteria:
* Medical criteria:
* Neurocognitive deficits not allowing for adequate preoperative education
* Congestive heart failure with EF \< 45%
* Symptomatic aortic stenosis causing heart failure, syncope, dyspnea or angina
* Pulmonary fibrosis or pulmonary hypertension
* COPD or home oxygen use \> 2L
* Chronic kidney disease of any stage.
* Lack of a caregiver at home or functionally bed-bound
* Ultralow pelvic resection
* Need for ostomy creation intraoperatively
* Operative time greater than 5 hours as this likely indicates a complex case and dissection necessitating closer monitoring in the hospital
* Conversion to open procedure intraoperatively
* Patients receiving antiplatelet agents such as clopidogrel, prasugrel, ticagrelor or ticlopidine within one year of coronary or carotid stent implantation, TAVR or LAAO placement.
* Patients on therapeutic anticoagulation medications such as warfarin, Eliquis, Xarelto, Enoxaparin
* Current tobacco use
* Patients who were unable to complete preoperative education, do not feel comfortable with care at home, or do not have an available caregiver for the first 7 postoperative days
* Any surgical history that would preclude safe abdominal entry for robotic surgery
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