Day surgery refers to a surgical procedure that takes place in a single working day, from preoperative preparation, the surgical procedure, postoperative recovery, and patient healing to a point that leaving the hospital is reasonably safe. Elective surgery is most commonly performed as day surgery—it is estimated that at least 70% of all elective surgeries are day surgery procedures. The term elective here is broadly applied since this can include both cosmetic and medical procedures that are not performed as an emergency or urgently.
The day surgery definition is synonymous with “same day surgery” and “outpatient surgery.” A similar concept today surgery is the idea of short-stay surgery in which the entire process takes place over less than 23 hours, but there is usually an overnight stay for purposes of observation during short-stay surgery.
The push toward day surgery has been made, in part, by health insurance companies. Health insurance companies dispute stays in the hospital and length of stays past a certain point. If the hospital stay is longer than what the health insurance company officials deem to be appropriate, they refuse to pay for the hospital stay. While this approach is objectionable to most, in many cases it has turned out to be reasonable. Apparently many patients do very well with day surgery procedures—the overnight stay in many elective surgeries is unnecessary. This is not true in all cases, but the concept of long hospital stays after surgery has been questioned over the past decade or so with a trend toward faster discharge and day surgery procedures.
Surgeons were initially leery about discharging patients on the same day as a surgical procedure. Originally, day surgery was limited to minor procedures like hemorrhoid removal or inguinal hernia repair. As these patients did very well with a more or less immediate discharge (after postoperative recovery), the day surgery definition expanded a bit. More surgeries were tried with the rapid discharge approach. Today, elective appendix surgery (appendectomy) and gallbladder surgery (cholecystectomy) are commonly performed as day surgeries.
The advent of laparoscopic surgery has helped increase the number of day surgeries. It stands to reason that if surgery can be performed by making a few small incisions rather than a large incision, the recovery process is much shorter and less painful. Consider surgery in the abdomen. Underneath the skin, there are layers of muscles and a tough tissue called fascia. In traditional open surgery, a large incision disrupts a lot of muscle fibers so that movement is slow and painful. In laparoscopic surgery, small areas of muscle and fascia are cut in several different locations. The surrounding muscles are left intact, which preserves function and reduces postoperative pain.
Another factor that has increased the number of day surgery procedures is a more educated, sophisticated patient population. Most patients can be trusted to follow the postoperative instructions and to look for early signs of complications. Excellent patient education at the point of discharge is critical to successful day surgery. Timely follow up appointments are important also to check for complications.
Today there are a considerable number of procedures performed as day surgery. These can be abdominal surgery, foot surgery, eye surgery, and others. Many cosmetic surgery procedures are day surgeries. If you are interested in whether your elective surgical procedure can be a day surgery, ask your surgeon. In general, it is favorable to perform many surgeries as day surgeries; however, more major procedures will require a short hospital stay.