The main reason for the emergence of one-day surgery was the disparity between what medicine at the highest level could offer its patients and what the state’s economy was able and willing to allocate for this care. In other words, thanks to its development and the advancement of human knowledge, medicine could provide care that is many times more expensive and in a much larger volume than any economy of any state has the financial means 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 ground at the turn of the century. Like anything new, it emerged gradually, in various modifications and forms. The development of one-day surgery in our country was equally slow. A major debate preceded it on the topic of which surgical procedures could be performed under the one-day surgery regime.
In 2011, the Czech Surgical Society’s committee adopted a specific list of surgical procedures that can be safely and appropriately performed under the one-day surgery regime. These are procedures that do not burden the patient to the extent that they would need to stay in intensive care after surgery, meaning that patients can safely and independently return home within 24 hours. These include gallbladder surgeries, hernia surgeries, appendectomy, surgeries on the lower limbs, specifically veins of the lower limbs such as varicose veins (varices), breast-related surgeries including malignant breast disease, surgeries in the rectal area such as hemorrhoids and benign fistulas. It also includes a full range of bariatric procedures, which are performed on overweight patients. From other surgical fields, it includes a variety of orthopedic procedures, such as arthroscopy and cruciate ligament reconstruction in the knee. In other fields (ophthalmology, otolaryngology), this development is progressing at an even faster pace.
The significant technological advancements of recent years have enabled surgeries to be performed under the one-day surgery regime. We now have access to modern equipment and devices for performing both laparoscopic and laser surgeries. There has also been progress in other areas, such as anesthesia, where today’s anesthetics are much gentler. An important benefit is the fact that one-day surgery specializes in a specific range of procedures, of which we perform a large number, thus gaining significantly higher expertise in this particular field. Naturally, surgeries take less time as a result. Any extension of the surgery or anesthesia duration impacts the patient, making their recovery after surgery more difficult. Our main focus is to operate as quickly and as gently as possible so that the patient is truly able, self-sufficient, and ready to go home after the mentioned 24 hours. If their health condition does not permit this, it’s not a major issue—they will stay with us for a day or two longer. However, this happens very rarely.
One-day surgery is, more than anything else, a regime of postoperative care for patients, 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/damaged” by surgeries and do not need to stay in the hospital as long. Therefore, it is possible for their postoperative recovery to take place at home, provided they have access to all necessary care and their health condition is stable enough that home care does not jeopardize proper postoperative healing.
Patients have grown very fond of this trend, particularly appreciating the ability to significantly shorten their hospital stay and recover at home, where they have more peace, familiar routines, and are in a much better mental state. Moreover, home care has been proven to accelerate the healing process.
