Day care surgery: The norm for elective surgery

Abstract

In the modern day hospitals, there is an established principle of ambulating the surgical patient as early as possible. This idea has gone a step further by discharging the post-operative patient home as soon as the critical period or immediate post-operative nursing needs have been met with. This has led to the concept of day care surgery. The notion of day care surgery goes back to the days of Dr. Nicoll, a surgeon and founder of modern ambulatory surgery, who published his landmark article on the surgery of infancy in 19091. He described a 10-year surgical experience at the outpatient clinic in the Glasgow Hospital for Sick Children in which 8988 patients were treated as outpatients after operation. Nearly onehalf of the patients were children less than 3 years of age. Dr. Nicoll performed 7392 of these operations himself. They included hare lips, cleft palates, hernias, and the like. His astounding accomplishments and philosophy, especially his criticism of hospitalization and his insistence on getting the children back to their nursing mothers as soon as possible has gained global acceptance with the result that during the last two decades, many different countries have experienced a spectacular change from inpatient to day-surgery.  Currently day care surgery is the norm rather than the exception.