In recent years, the number of outpatient operations has increased significantly. New surgical procedures, especially the so-called imaging techniques to assist in operations, but also innovative materials and devices make interventions in the human body increasingly easier.
Outpatient = cheaper?
With the need for hospitals to save on all costs, outpatient surgery seems to be a real alternative to expensive and long hospital stays. But the equation "ambulant = short, uncomplicated and cheap" does not work out easily. For a patient to be successfully operated on an outpatient basis, some requirements must be met.
The criteria for outpatient surgery are the minimal risk of rebleeding, a minimal risk of postoperative respiratory complications, no special postoperative care needs, and the ability to quickly take fluid and food after surgery.
Which diseases are suitable?
The following diseases or interventions are particularly suitable for an outpatient procedure:
- afford testicles
- umbilical hernia
- Water breakage (hydrocele)
- varicose veins
- Varicose veins (varicocele)
- Arthroscopy (knee reflexology)
- metal removal
- bone fractures
- Interventions on the teeth
Care and aftercare
The patient not only has to understand the intrinsic treatment and its consequences, but also has to ensure that his transport to the outpatient surgery is as assured as his return home. His apartment must be equipped with light, heating, bathroom, toilet and telephone. He must also be able to ensure that he is available and responsive either by himself or by a caregiver after surgery. For the time after the operation at home, it must be ensured that the patient can be treated promptly in case of possible complications.
The aftercare - either in the office or on-site visit - must be discussed in the preliminary discussion and clarified. The patient must be in good general condition; Pregnant women and infants should not be operated on an outpatient basis or only after close consultation. Also, the doctor and the clinic in which the outpatient surgery is performed must be set up accordingly. The operating rooms including recovery room and control facilities must comply with legal requirements; Similarly, appropriately trained surgical and nursing staff must be present.
A close connection to inpatient treatment is required according to the guidelines of the German Society for Anaesthesiology and Intensive Care Medicine (DGAI) as well as a sufficient and easily accessible number of wheelchairs and parking lots.
The preliminary talk
If the general practitioner has made the diagnosis of a disease requiring surgery and advised the patient accordingly, the first contact with the surgeon is made. In this interview patients should have the opportunity to discuss all questions without time pressure.
The physician must conscientiously educate the patient on all aspects and examine the need for any preliminary examinations. During this preliminary discussion, the surgery date will be determined and all necessary instructions regarding anesthesia preparation will be discussed.
The day of surgery
The instructions of anesthesiologists regarding sobriety and the use of medication must be strictly adhered to. Anyone who feels ill shortly before the procedure should definitely consult with the doctor again and postpone the surgery appointment in case of doubt. The patient should be accompanied on the day of the operation by a familiar person, who is usually allowed to visit him after the procedure.
The duration of the follow-up time depends on the individual condition of the individual patient and is very variable. For any waiting time both before and after the procedure, it is worth taking books, cassettes and CDs.
An ambulatory patient is released only when circulation and cardiac function are normal for at least 60 minutes. The patient must be able to recognize time, place and known persons and be able to dress and move according to his preoperative state. Nausea, vomiting or dizziness should be minimal, as well as wounds should bleed only minimally and show no signs of inflammation.
The patient must always be dismissed by the surgeon and the anesthesiologist. For all relevant aspects of anesthesia and postoperative follow-up, appropriate instructions must be given to both the patient and the accompanying person. In addition, the patient must be provided with a contact address for emergency and adequate pain medication.
The aftercare at home
Those who recover after outpatient treatment at home often feel better there than in the clinic. Nevertheless, it should be ensured that help is available in the household and that an adequate recovery period is maintained.
Even if the procedure was "only" outpatient, it should not be taken too "easy". An outpatient procedure is not automatically a "simple" procedure for the patient. For all questions and potential concerns or complications, consult with the attending physician immediately.