Introduction/Background Laparoscopic hysterectomy has been named a key procedure for improving day case rates in the Sept 2020 National Day Surgery Delivery pack – A collaborative document involving ‘Getting it right first time’, ‘Centre for pre-operative care’ and the ‘British Association of Day Surgery.’ The COVID pandemic, along with general winter pressures on availability of hospital beds led us to developing a new pathway for day-case minimal access hysterectomy. Our aim was to implement day-case minimal access hysterectomy in Queen Alexandra Hospital, Portsmouth and to audit the complication rates.

Methodology All suitable patients were offered day-case minimal access hysterectomy from 1stDecember 2020 and all patients discharged home the same day had the data prospectively collected to monitor potential complication rates. For comparison, complication data was collected from a cohort of patients admitted overnight for a minimal access hysterectomy from the surgeon (a gynaecological-oncology consultant) with the highest uptake in day-case hysterectomy.

Results From the 1st December 2020 to the 25th January 2022 28 patients went home on the day of their minimal access hysterectomy (20 were done by the same surgeon (Surgeon 1). In the same timeframe Surgeon 1 admitted 27 minimal access hysterectomies overnight. The complication rate for same day discharge was comparable, with no day-case hysterectomies re-presenting to hospital within the first 7 days post-surgery. Complications in the day-case group: Mild vaginal bleeding n=2; one patient readmitted with infected vault haematoma. Complications in the patients that stayed overnight: One patient was admitted with a vault haematoma and one patient was admitted with aspirational pneumonia.

Conclusion In suitable patients day-case hysterectomy is safe, with a comparable complication rate to patients admitted overnight, and offers significant cost-savings. There were no adverse outcomes in the first week post-surgery in patients wishing to be discharged home the same day of surgery.