Talk Descripción
Institución: Royal Perth Hospital - Western Australia, Australia
Purpose:
Ambulatory colectomy is reported as safe internationally for selected patients within enhanced recovery programs but is not routinely practiced in Australian public hospitals. We established an ambulatory laparoscopic colectomy pathway in a Western Australian public hospital and report early feasibility from an ongoing prospective pilot.
Methodology:
We prospectively enrol patients undergoing elective laparoscopic colectomy who meet strict criteria: low comorbidity burden, suitable indication, reliable home support, and ability to return promptly if concerns arise. The pathway includes preoperative counselling and expectation-setting, multimodal analgesia, early mobilisation, predefined ambulatory discharge criteria, and structured follow-up via Hospital in the Home visits, phone calls, site visits and early clinic review. Ethical approval was obtained.
Results:
Clinic discussions showed strong interest, but eligibility requirements limited recruitment. One patient has completed ambulatory colectomy to date without unplanned admission, early complications, or readmission, and reported high satisfaction with counselling, clear discharge expectations, and early follow-up. Barriers included the narrow selection window, postoperative ward workflow constraints, and the need for consistent engagement across perioperative teams to make ambulatory discharge possible in a public hospital setting.
Conclusion:
Early experience supports proof of concept for ambulatory colectomy in a Western Australian public hospital when applied to carefully selected patients within a defined pathway. Operational factors currently limit recruitment and scalability; ongoing enrolment will clarify feasibility and guide pathway refinement for broader implementation.
Speakers
Contributors
Authors
Dr Da Wei Thong - , Dr Linda Vu - , Dr Abraham Jacob - , Dr Ruben Rajan - , Dr Mary Theophilus -
