Chapter 42: The Kinder Cut: Surgery Made Easy
|In a good surgeon, a hawks eye; a lions heart; and a Ladys hand.
- Leonard Wright
Most of us become petrified at the very thought of having to undergo surgery, and one of the major worries is the fact that hospitalization is needed. After all, hospitals can be terrifying places for patients! Fortunately, there is now a kinder option available for many patients who need to undergo surgery, namely, which does not need to spend time in hospital, and this is called day-care surgery (also known as ambulatory surgery or same-day surgery).
Day-care surgery has become increasingly popular all over the world, for many reasons. First, thanks to tremendous advances in technology, many doctors have started performing minimally invasive surgical procedures. These procedures use endoscopes, and require very small incisions, so that the risks involved in conventional major surgery can be avoided. Secondly, the newer drugs used for anesthesia allow patients to recover consciousness very quickly, so that they can go home soon after the surgery is over. Finally, since modern painkillers are more powerful, patients have much less pain after the operation and they can successfully relieve the pain themselves by taking these medications at home.
Ambulatory surgery allows patients to recuperate where they are most comfortable--in their own home ! This is now a global trend, and over 50% of elective surgery in the USA is now done on an ambulatory basis. This fact is not surprising, given the various benefits ambulatory surgery offers patients. Patients find day-care surgery much less stressful, as short recovery times allow anxious patients to be comforted soon after surgery, by their relatives and they dont need to be isolated in a hospital room. Moreover, patients do not suffer from separation anxiety, as they do not need to be separated from their families overnight --- something which is especially helpful for children. Ambulatory surgery means less time away from home, less time off from work, and less disruption of the patients schedule. Patients are happier, because they remain in a single unit which has been planned, and is operated, solely for their safety and comfort. Patients prefer ambulatory surgery over hospital outpatient departments because the former involves less paperwork, little waiting and more organized and friendlier staff compared to crowded and uncomfortable hospital settings, where day care surgery patients get low priority, because their surgery is usually scheduled last, after the major operations.
Studies worldwide have shown that ambulatory surgery delivers the same high-quality care as that given to hospital patients. The first ambulatory surgery center was setup in the USA in 1970. Today, almost five million surgeries are performed each year in the more than 2,400 surgery centers across the United States. While day-care surgery is still a very new concept in India, it is heartening to observe that is becoming increasingly popular day-by-day.
Because the expenses incurred during a hospital stay are eliminated, ambulatory surgery usually costs less than the same type of surgery done for a hospital inpatient. This is a benefit that everyone --- insurance companies, business organizations, surgeons and patients --- greatly appreciate! Day-care surgery centers, provide high-quality health care at lower costs compared to hospitals because they maintain low overhead costs and also because they can focus only on aspect: treating ambulatory patients efficiently. On an average, procedures at ambulatory surgery centers cost 47 percent less than those at hospitals. (This figure is based on a study conducted by Blue Cross/Blue Shield of North Carolina).
Some patients still prefer undergoing surgery in a large hospital, because they feel it is safer in view of the backup facilities the hospital can provide in case of an emergency, paradoxically, day care surgery centers are safer because they are dedicated to performing only ambulatory surgery, so that there are no "sick" patients; and there is no risk of acquiring hospital - generated infections. In a surgery center, patients receive more individual personal care as compared to the impersonality of a large hospital. Ambulatory surgical units have achieved an excellent record throughout the world, with a very low incidence of complications, because of careful patient selection; and adequate back-up facilities to meet any emergency .
Of late, patients and surgeons alike are increasingly, learning the benefits of outpatient surgery centers. Healthy patients find such centers much more comfortable than hospitals, which are primarily designed for the very ill. Family members also prefer day care surgery, because they can take care of the patients themselves, rather than leave them in an impersonal hospital room. Surgeons also find scheduling their outpatient activities much easier at an ambulatory surgery center, because problems with hospital waiting lists or booking a hospital room do not exist. They also find that since the cost of a hospital stay is eliminated, they can provide quality care to their patients at a lower rate.
Of course, day care surgery is not applicable to all patients. Thus, those patients who suffer from a serious medical illness; or those who need complex surgery; or those who do not have family members, will still need hospitalization for their surgery.
The majority of procedures performed in ambulatory surgery centers fall into the following categories: (1) eye surgery, including removal of cataracts, eye muscle surgery and removal of foreign bodies; (2) gynecological procedures including dilation and curettage (D&C), laparoscopies and biopsies; (3) ear/nose/throat surgery such as removal of tonsils and adenoids; (4) bone surgery, such as biopsies , bone grafts, and arthoscopic surgery; (5) general surgery such as breast and muscle biopsies, hernia repair, hemorrhoid operations and laparoscopic cholecystectomies; and (6) cosmetic surgery such as scar revision, skin grafts and facial surgery .
Many factors, including medical advances, patient awareness and economics are the primary driving force behind the growth in ambulatory surgery centers. All aspects considered, ambulatory surgery is likely to become an increasingly popular option in the future!