Expert Insights by Dr Vivek: Traditional Surgery vs. Daycare Pediatric Surgery
Overview
In a recent conversation with The Aartey Chronicles, Dr. Vivek Viswanathan, a paediatric urologist, and minimally invasive surgeon with extensive experience in laparoscopic and robotic techniques, discussed the evolution and application of daycare surgery. He highlighted that daycare surgery involves procedures that are completed within a single day, allowing the patient to go home on the same day of the surgery.
Dr. Viswanathan has worked extensively at the Koki Lab in Dhirubhai Ambani Hospital, Mumbai, before returning to Vadodara, Gujarat, to practice exclusively in pediatric urology.
In this article, Dr. Viswanathan distinguishes between traditional and daycare surgeries, noting that daycare procedures are streamlined for quick recovery and same-day discharge.
He explains that while daycare surgeries are efficient and minimize hospital stays, traditional surgeries are suited for more complex cases needing extended postoperative care and detailed management.
Traditional Surgery vs. Daycare Surgery
When considering paediatric surgical interventions, the choice between traditional surgery and daycare surgery hinges on various factors, including the complexity of the procedure and the child’s overall health. Traditional surgeries typically involve more extensive procedures and require prolonged hospital stays, providing comprehensive management and close monitoring, especially for high-risk or complex cases. In contrast, daycare surgeries are designed to be completed within a single day, allowing for a quicker recovery and discharge, provided the child is in good health and the procedure is relatively straightforward. Understanding the distinctions between these approaches helps in determining the most appropriate surgical care for young patients.
Pre-Anaesthetic Checkup in Daycare Surgeries vs. Traditional Surgeries
Daycare Surgeries
In daycare surgeries, the pre-anaesthetic checkup is generally streamlined due to the shorter nature of the procedures. Anaesthetists often assess the child on the morning of the surgery, focusing on immediate risks and ensuring the child is fit for the planned procedure. The goal is to prepare for a quick recovery, allowing the child to go home the same day. The assessment typically includes a review of medical history and a quick physical evaluation.
Daycare Surgeries
For traditional surgeries, particularly those involving more complex or high-risk cases, the pre-anesthetic checkup is more thorough and extensive, involving the following steps:
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- Pre-Anesthetic Evaluation: The anesthetist evaluates the child’s overall risk, discusses potential complications with the parents, and coordinates with the surgeon to plan the necessary precautions.
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- Preparation for Complications: Arrangements are made for any potential complications, such as having blood products ready if needed. This ensures that any issues can be promptly addressed during and after the surgery.
Comparing Traditional Surgery Protocols and Daycare Paediatric Surgery Protocols
Traditional Surgery Protocols
In certain cases, involving comorbidities or chronic conditions that preclude daycare surgery, traditional surgical approaches become necessary. These approaches facilitate more comprehensive management and provide extended postoperative care to ensure the child’s well-being.
- Admission to Intensive Care: For children with poorly controlled systemic diseases, admission to a pediatric or neonatal intensive care unit may be required. This ensures that the child receives the specialized care needed for their condition.
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- Comprehensive Preoperative Assessment: A thorough investigation of the child’s systemic disease is conducted. This includes obtaining pediatric fitness for surgery, assessing all associated risks, and preparing for any potential complications.
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- Extended Postoperative Observation: Post-surgery, the child requires observation beyond the usual daycare timeframe. This may involve a hospital stay of a few days to ensure the child’s recovery and management of their systemic condition.
Daycare Surgery Protocols
In contrast, daycare surgeries follow a streamlined process:
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- Immediate Post-Operative Care: After surgery, once the child wakes up and the effects of anaesthesia wear off, they are started on oral feeds.
- Rapid Discharge: Provided the child has passed urine and is pain-free, discharge typically occurs within two to three hours post-surgery.
Pre-Anaesthetic Checkup in Daycare Surgeries vs. Traditional Surgeries
Daycare Surgeries
In daycare surgeries, the pre-anaesthetic checkup is generally streamlined due to the shorter nature of the procedures. Anaesthetists often assess the child on the morning of the surgery, focusing on immediate risks and ensuring the child is fit for the planned procedure. The goal is to prepare for a quick recovery, allowing the child to go home the same day. The assessment typically includes a review of medical history and a quick physical evaluation.
Traditional Surgeries
For traditional surgeries, particularly those involving more complex or high-risk cases, the pre-anaesthetic checkup is more thorough and extensive, involving the following steps:
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- Pre-Anaesthetic Evaluation: The anaesthetist evaluates the child’s overall risk, discusses potential complications with the parents, and coordinates with the surgeon to plan the necessary precautions.
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- Preparation for Complications: Arrangements are made for any potential complications, such as having blood products ready if needed. This ensures that any issues can be promptly addressed during and after the surgery.
Conclusion
In conclusion, the choice between daycare and traditional surgeries depends on the child’s medical needs and the complexity of the procedure. Daycare surgeries offer convenience and reduced hospital time for many cases, while traditional surgeries provide the comprehensive care and extended observation required for more complex or high-risk situations.
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