One of the greatest advantages of one-day surgery is the greater psychological comfort for the patient. There is a saying, “There’s no place like home.” A patient heals better when at home, and if it is not necessary for them to be in the hospital, one-day surgery allows for this benefit.
Classical medicine in the past did not take psychological influences into account very much, but it is now known that a patient who is in a good mental state tolerates the “ordeals” that every surgery entails significantly better.
Other advantages of one-day care include:
The main reason for the emergence of one-day surgery was the imbalance between what medicine at the highest level could offer its patients and what the state’s economy is able and willing to allocate for this care. In other words, medicine could, thanks to its development and the advancement of human knowledge, provide care that is many times more expensive and in much larger volumes than any economy in any state has the financial resources for. For this reason, it was necessary for the funds allocated by the state for healthcare to be used as efficiently as possible. This is one of the main reasons why one-day surgery emerged in Britain, America, and Western Europe. Simply put, it is cheaper for health insurance payers.
In our region, one-day surgery began to slowly gain traction at the turn of the century. Like all new things, it emerged gradually, in various modifications and forms. The development of one-day surgery in our republic was equally slow. This was preceded by extensive discussions on which surgical procedures would be possible to perform in a one-day surgery setting.
In 2011, the committee of the Czech Surgical Society approved a specific list of surgical procedures that can be safely and appropriately performed in a one-day surgery setting. These are surgical procedures that do not burden the patient to the extent that they would require a stay in an intensive care unit after the surgery, allowing the patient to safely and independently return to home care within 24 hours. This includes gallbladder surgeries, hernia repairs, appendectomies, surgeries on the lower extremities, including varicose veins, surgeries related to breast diseases, including malignant breast conditions, and surgeries in the area of the rectum, such as hemorrhoids and benign fistulas. The list encompasses a full range of bariatric procedures performed on overweight patients. In other surgical specialties, such as orthopedics, procedures like arthroscopy and cruciate ligament reconstruction in the knee are included. In other fields (such as ophthalmology and ENT), this development is progressing at an even faster pace.
The significant technical advancements of recent years have made it possible to perform surgeries in a one-day surgery setting. We have modern equipment and instruments available for conducting laparoscopic and laser surgeries. Developments are also occurring in other areas, such as anesthesia, where modern anesthetics are much gentler. An important benefit is that one-day surgery specializes in a specific range of surgical procedures, which we perform in large numbers, thereby gaining significantly higher expertise in this particular area of surgery. Consequently, surgeries naturally take less time. Any extension of the surgery or anesthesia has an impact on the patient, and their recovery after surgery tends to be more challenging. Our primary interest is to perform surgeries as quickly and gently as possible so that the patient is indeed capable, self-sufficient, and ready to return to home care within the mentioned 24 hours. If the patient’s health does not allow for this, they may stay with us for an additional day or two. However, this happens very rarely.
One-day surgery is, more than anything else, a postoperative care regimen for patients that is made possible by the advancement of surgical technology, particularly with the development of laparoscopy, arthroscopy, and various endovenous treatment options, such as for varicose veins. Thanks to these methods, patients are less “burdened/harmed” by surgeries and do not need to stay in the hospital for long periods. Therefore, it is possible for their postoperative recovery to take place in a home environment, provided they have all the necessary care and their health condition is stable enough that home care does not jeopardize their proper postoperative healing.
Patients have greatly embraced this trend, especially appreciating the opportunity to significantly shorten their time spent in the hospital and recover at home, where they enjoy greater peace, familiarity, and a much better mental state. Moreover, home care has been shown to accelerate the healing process.
