Everything You Need to Know About Daycare Surgeries

In the highly advanced technological epoch, Daycare Surgery has been gaining massive momentum. It has brought a revolution in the medical sector. Daycare surgery is a type of ambulatory surgery wherein a patient undergoes surgery and can be discharged on the same day of surgery. Usually, patients with minor diseases undergo daycare surgeries.

In the case of such patients, they don’t actually need an overnight stay at the hospital instead, they can get discharged in less than 24 hours. In the current contemporary times, daycare surgeries have gained immense popularity and are being implemented across several multi-specialty hospitals. This blog helps you to gain more awareness and knowledge about daycare surgeries and significance.

Here is an excerpt from a video interview with Dr. M Raja, Consultant General Surgeon at Omni Hospitals, Vizag on the topic ‘Daycare Surgeries.’ Get to know more about the evolution, benefits and other information about Daycare surgeries through this guide.

Q. What is Daycare Surgery?

A.Daycare Surgery is the modern type of surgery wherein the patient usually undergoes surgery in the morning and can be discharged on the same day in less than 24 hours. If the patient gets admitted in the morning, undergoes the surgery and can be discharged in the evening. This is the actual concept of daycare surgery.

Q. When did the Daycare Surgery concept originally evolved?

A.Daycare Surgery was actually evolved several decades ago i.e., around 1909. A Scottish surgeon named James Nicoll actually started daycare surgery in the year 1909. He worked at a hospital in the Glasgow, Scotland, where he saw a lot of paediatric patients were treated for hernia and hairlip surgery and were discharged on the smae day. After a decade i.e., around 1919, an anaesthetist namely Ralph Walter witnessed a tremendous response to daycare surgeries. He then planned to setup a daycare unit. Later, some other surgeons followed this concept of surgeries. This way, Day Care Surgery has gained a lot of popularity across the globe. The prominence and benefits of Daycare Surgery expanded to several countries like England, USA, India and more.

Q. What facilities are required to set up a Daycare Surgery?

A.Daycare surgeries are quite different from traditional surgeries and some other elective surgeries. Whenever a patient comes to the out-patient department, they will get examined. Later, the surgeons categorize whether the patient is eligible for the in-patient category or daycare surgery. Several facilities are required to perform a daycare surgery. Some of them include:

• Surgeon
• Anesthetist
• Floor Managers
• Operational Managers
• Nursing Staff

All of them form a dedicated team unit and strive hard in making a daycare surgery successful.

Q. What is a day surgery cycle?

A. Once a doctor or a general practitioner checks the patient, they will get some assessment about the patient in the clinic. Before the daycare surgery, the patient goes to the pre-assessment room. An anesthetist performs all the necessary assessments pertaining to the disease. The anesthetist will choose the type of anesthesia based on a few factors like the patient’s condition, disease type and more.
The patient then goes to the operating room. Once the surgery is done, the patient will be taken to the recovery room. Later, the patient will be discharged once he or she is completely fit after the surgery. This is the complete cycle of daycare surgery.

Q. What factors are considered for the daycare surgery process?

A. There are copious factors that are involved in the process of daycare surgeries. The selection of the patient is highly important to get good results and gain success in daycare surgery. Some other social factors are also crucial in this process.

Good Caretaker

There must be a person to look after the patient once he or she gets discharged after the surgery. The caretaker should be available for the next 24 hours to the patient soon after the surgery.

Emergency Conditions

If there is any sort of emergency, they need to have the capability of bringing the patient immediately to the hospital.

Contact Numbers

The patient should have all the essential emergency contact numbers so that they can contact the doctor whenever a health problem arises after reaching home.

Environmental Conditions

The environment is another important factor i.e., the place where the patient stays should be very clean.

Medical factor

These factors are also vital in this process. If the patient is having Diabetes Mellitus, respiratory problems, hypertension, cardiovascular diseases and other problems, they must consider all of them before doing the daycare surgery.

Obesity

If the BMI [Body Mass Index] of the patient is between 30 and 37, the patient can go for daycare surgery by taking adequate precautions. If the BMI is more than 40 then, they are unfit for the daycare surgery. Obesity plays a crucial role in this surgery process.

Smoking

It is another important factor that must be considered before this surgery process. Before undergoing the surgery, the patient has to stop smoking at least 48 hours prior to the surgery.

All the aforementioned social factors are very important for daycare surgery procedures.

Q. What investigations are required for daycare surgeries?

A. If the patient is asymptomatic and absolutely fit then, the surgeons won’t refer to many investigations. If the patient is symptomatic or has any other health problems like diabetes, hypertension, asthma, cardiovascular or respiratory disorders, they will try to evaluate the complete blood cell count i.e., CBP. The doctors also check the hemoglobin percentage whether the patient is anemic or not.

Some other investigations include complete urine examination, blood urea, serum test, renal tests, ECG and chest X-ray. These are the most basic and common tests that are done for some surgeries. If it is abdominal surgery like Appendix, Gallbladder surgery or others then, it is necessary to do a few investigations like ultrasound, abdomen scanning, CECD of abdomen and others. Hence, the investigations are based on the type of surgery, disease type, patient’s condition and more.

Q. What should be the ideal condition of the patient for a daycare surgery?

A. If the ideal patient is fit enough, non-smoker, having perfect BMI and has no health issues then, such patients are ideal and perfect for a daycare surgery.

Q. What are the most common daycare surgeries?

A. Mostly, daycare surgeries involve a lot of medical departments. It ranges from Pediatrics to elderly people. Some of them include general surgery department, ENT, Orthopedics, Gynaecology, Cardiovascular department, Neurology and more. The most common procedures that are done in general surgery include thyroid cysts, benign swellings in the neck, submandibular glands, superficial parotidectomy and others.

If there are small cysts anywhere in the body, they can be removed through daycare surgeries. The daycare surgeries will be involved in any of the aforementioned departments. These kind of surgeries can be done to people right from the kids to adults.

Q. What is the role of the Anesthetist in daycare surgery?

A.An Anesthetist role is extremely important in daycare surgeries. Usually, experienced anesthetists have the ability to make the daycare surgeries successful. Once the patient is selected for a daycare surgery, he or she goes to a pre-assessment checkup which is done by the anesthetist.

Q. What kind of anesthesia is preferred?

A. Based on the type of anesthesia given to the patient, the surgery will become successful. The anesthetist will give anesthesia to the patient in some parts before the surgery. There are 4 different types of anesthesia. General anesthesia is given to patients who undergo abdominal surgeries. Local anesthesiais is a type of anesthesia given to a small area on the body.

In this type, the patient will remain awake and alert. In the case of regional anesthesia, it blocks pain in a particular part of the body like the arm or leg. In some other types of surgeries like pelvic surgeries, below umbilical surgeries, spinal anesthesia is required. Despite having several types of anesthesia, local anesthesia and regional anesthesia are the most popular types.

Q. What are the benefits of daycare surgery over traditional surgery?

A. There are several benefits of daycare surgery over traditional surgery.

• In the case of traditional surgery, the patient has to stay in the hospital for a few days or weeks. Moreover, the patient may get infections for remaining in a room for more than a week. The charges for staying in the hospital also increases in traditional surgeries.
• Early mobilization i.e., ability to walk around is one of the greater advantages of daycare surgery.
• The patient may feel less pain in the location of the surgery as it involves minimally invasive surgical techniques.
  The patient can be discharged from the hospital on the same day of the surgery.

Q. What kind of role does nursing staff play during a daycare surgery?

A. A daycare surgery is an independent unit that comprises a surgeon, an experienced anesthetist, experienced nursing staff, managers and more. The role of the nursing staff is very much crucial during or after a daycare surgery. They need to look after the patient every now and then after shifting them from the operation theatre to the ward or recovery room.

The nursing staff must see whether the patient is having pain, vomiting, urination and more. They need to check all these things every hour and report the same to the consulting doctor. So, the nursing staff should be highly experienced in taking care of the patient during and after a daycare surgery.

Q. What is the recovery process followed in daycare surgery?

A. After the completion of the surgery, the patient goes through two phases. The first phase is the recovery phase. In this phase, the patient will be stabilized until the vitals are stable. The patient will have less pain, minimal dizziness, less nausea and less vomitings. Such patients can directly go for the second phase of recovery room.
In the second phase, the patient is absolutely fine and is conscious enough, they can go back home in the evening after the surgery. If the patient takes more time in the first recovery phase, they will remain for some more time in the hospital than usual.

Q. What are the post-operative instructions given to the patient at the time of discharge?

A. The patient must and should follow the post-operative instructions. The caretaker should take the best care of the patient once they get discharged. The caretaker will be given some instructions if any health issues arise once the patient is taken home. If the patient complains of infections, pain, nausea, dizziness, bleeding and other complaints following surgery, the caretaker should immediately contact the corresponding person in the hospital.

This way, the patient’s suffering will be reduced. The caretaker should be available for the next 24 to 48 hours with the patient following the surgery. Some other instructions are related to the diet that should be followed by the patient post-operation. The patient is not allowed to drive all by himself or herself to home. The caretaker should accompany the patient until they reach home.

The patients should be placed in a well-ventilated and very neat and tidy room at home. They need to stay closer to the washrooms, telephone and the caretaker as well. If the patient is bleeding or come across any other health problem, the caretaker should immediately inform the specialist so that necessary action will be taken promptly to treat it.

Q. What kind of post-operative complications are expected in a daycare surgery?

A. Usually, the complications are classified into two types i.e., major and minor. But, in the case of daycare surgery, the patient will be evaluated at least a few weeks before the surgery. The surgeons will proceed with the surgery only after ensuring that there are no complications post-surgery.
They make sure that there are no complications in the surgeon’s aspect as well as in the anesthetist aspect. There will be minor complaints after a daycare surgery. Mostly, the patient complains of having pain or not passed the urine or stools after the surgery. By informing these problems to the nursing staff or the concerned doctor, they will provide effective treatment immediately.

Q. What are the advantages of daycare surgery?

• Faster Recovery
• Lesser Hospitalization course
• Peacefulness to the patient
• Not prone to hospital infections i.e., nosocomial infections

Q. What are the contraindications for a daycare surgery?

A. If the patient has uncontrolled hypertension, severe respiratory disorders, smoker, obese is considered the major contraindications for daycare surgery. The surgeons often suggest such patients go for elective surgeries. In any kind of surgery, such patients will be recovered in a better way without confronting any of the complications. Whether it is a traditional or elective or a daycare surgery, proper care should be taken for such patients.