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Old 15.02.2015, 19:10
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Hospital stay for straightforward surgery?

Hello,

I'm due to have surgery in a few weeks for a hernia. It's a very common procedure (keyhole) and only takes about 30 minutes though it will be done under general anesthetic.

The strange thing is that my surgeon says I'll need to stay in hospital for two nights. Everything I've read about the procedure elsewhere (e.g. US, UK, Scandinavian health authorities) says that the surgery is straightforward and normally done on an outpatient basis so you go home the same day.

I haven't been in Switzerland long so I'm wondering if this kind of precautionary approach is typical here, or if it's just so they can charge more money. I've no desire to stay in hospital if it's not necessary. And I can think of no health reasons for keeping me in.

I'm going to ask the surgeon at my pre-op consultation in a week's time but just wondering if anyone has had any similar experiences.

Thanks!
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Old 15.02.2015, 19:53
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Re: Hospital stay for straightforward surgery?

They do tend to be very cautious here, and it's normal to stay the night before a general anaesthetic, so they can do any tests or preparatory exams, paperwork, etc. etc. in advance, and possibly get you ready for surgery early morning. Having all the patients in house allows them to properly schedule surgery time. (That's what they say).

The night after is perhaps OTT, but again they tend towards over-caution in many cases. As your surgery _may_ be late in the day it allows more recovery time.

Yes, it seems perhaps unnecessary, especially compared with the UK, for example, where they're keen to get you in and out as quickly as possible to save costs and minimise risk of infection. These aren't really issues in CH, so they do what they think is the best for the patient's care.
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Old 15.02.2015, 19:57
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Re: Hospital stay for straightforward surgery?

I´d be rather shocked if the hospital did an operation like that and sent me home immediately? Yes, hospitals are cautious but do not keep you longer than necessary. Before my op I was told that I´d have to stay a week and I was back home on day 5. Just cautious
And good luck with your operation!
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Old 15.02.2015, 19:59
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Re: Hospital stay for straightforward surgery?

Another reason is that sometimes, due to other emergency surgery, your op could be postponed until later that day. The OH had that happen to him, was scheduled for morning surgery, but it didn't happen until that afternoon. So the overnight was even more important.
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Old 15.02.2015, 20:04
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Re: Hospital stay for straightforward surgery?

They normally let you out as soon as you can get around by yourself and take care of yourself…. that's just an estimate, they may let you out sooner.
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Old 15.02.2015, 20:21
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Re: Hospital stay for straightforward surgery?

My understanding of hospitals here is that if the surgery needs revising for reasons related to cases that could have been avoided, then the surgeon/hospital pay the costs, not the insurance company. Hence they tend to take a more thorough approach to primary cases to ensure they keep revisions/complications as low as possible.
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Old 15.02.2015, 20:44
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Re: Hospital stay for straightforward surgery?

Why not ask your health insurance company if they think this is normal? Maybe they are not using keyhole techniques, maybe you are a high risk patient?
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Old 15.02.2015, 21:01
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Re: Hospital stay for straightforward surgery?

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They normally let you out as soon as you can get around by yourself and take care of yourself…. that's just an estimate, they may let you out sooner.
Yes, that's happened to me, was supposed to stay the night before and after, but the doctor let me go later that day (after the epidural wore off).

Tom
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Old 16.02.2015, 04:18
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Re: Hospital stay for straightforward surgery?

I had hernia surgery (you mean a disc hernia, right?) at the Bethesda Spital in Basel last September. I was kept 6 days due to some complications and until I was feeling well enough to walk around. The anesthesia took a very long time to wear off. Personally I was pleased to have some time to myself on the Krankenkasse's dime. The food is excellent there.
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Old 16.02.2015, 09:01
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Re: Hospital stay for straightforward surgery?

I had breast surgery (duct removed) here last Sept. In the US this would have been done as outpatient surgery. I was told 2 nights by my Dr. I questioned it as I really hate spending time in the hospital and she said we could see but that people usually stay 2 nights. (I was not asked to come the night before.)

After the first night I chose to go home the next day. Honestly, I had planned to do this so I didn't bring any books, etc. with me and I was bored. In retrospect, I wish I had stayed another night so they could've removed my dressing instead of me having to do it myself. Personally, if I had it to do again, I'd take their advice and stay as long as possible. (The place was really nice too.)

I only have basic coverage and cost wasn't an issue - I was not charged for the hospital stay.

Whatever you decide, good luck with the surgery and fast healing!
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Old 16.02.2015, 09:45
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Re: Hospital stay for straightforward surgery?

I think it very much depends on the doctor, the individual circumstances of the patient and the type of surgery.

From my experience here, the doctor has not requested staying in hospital the night before, but particularly after general anaesthetic, at least one night of stay. It really depends on the nature of surgery, how mobile you are afterwards, and if there are any complications.

Definitely discuss this at the pre op appointment with your specialist.
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Old 16.02.2015, 09:51
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Re: Hospital stay for straightforward surgery?

I had surgery a couple of years ago. The doctor initially said that I would need to stay in the hospital at least a week - but when I explained that I didn't have a sitter to take charge at home he said no worries, the surgery could easily be done outpatient as well.

From 7 days to same day outpatient - quite a difference, especially wrt costs. Anyway, my insurer was happy that I asked about, and chose, outpatient treatment. Makes you wonder how much money is spent unnecessarily, as it seems up to the patient to explore options.

---

Mickster, do talk to your doctor and the surgeon about whether outpatient is available and appropriate for your case.

Wishing you all the best with your treatment.
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Old 22.02.2015, 13:57
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Re: Hospital stay for straightforward surgery?

in the US, they approve you for the minimum, and if more time is needed, then ask for it, but the policy is to aim for a 23 hour (or less) admission for many things. In Switzerland, they approve you for the maximum and if the physican and patient agree, send you home earlier.

Somewhere in the middle is nirvana, but I like the over cautious stance a bit better.

With laproscopic surgery, there is always the possibility of a complication and a need to do the more conventional surgery, so the Swiss are cautious.

I had a lumpectomy 4 years ago (chunk of breast removed). I expected to stay for 2 days, and possibly more if further surgery was required. Day after surgery( needed nothing extra), my physican asked me if i wanted to go home and i did, but it was nice to have the option.

When you leave the hospital in the US, they wheel you out. In Switzerland, the nurse shook my hand and i walked out of the room on my own.
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Old 22.02.2015, 14:07
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Re: Hospital stay for straightforward surgery?

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Hello,

I'm due to have surgery in a few weeks for a hernia. It's a very common procedure (keyhole) and only takes about 30 minutes though it will be done under general anesthetic.

The strange thing is that my surgeon says I'll need to stay in hospital for two nights. Everything I've read about the procedure elsewhere (e.g. US, UK, Scandinavian health authorities) says that the surgery is straightforward and normally done on an outpatient basis so you go home the same day.

I haven't been in Switzerland long so I'm wondering if this kind of precautionary approach is typical here, or if it's just so they can charge more money. I've no desire to stay in hospital if it's not necessary. And I can think of no health reasons for keeping me in.

I'm going to ask the surgeon at my pre-op consultation in a week's time but just wondering if anyone has had any similar experiences.

Thanks!
If you mean herniated disc (bandscheibenvorfall) in your back you could stay in hospital for a week. If you mean a normal hernia ( leistenbruch)
Then it's max 2 nights, but usually you may go the next day. Do you have private insurance?

If you've got a normal hernia I wouldn't go for a general anaesthetic but an epidural

Good luck in any case!
DrMidfieldGeneral
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Old 22.02.2015, 14:48
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Re: Hospital stay for straightforward surgery?

I had two hip surgeries in the last two years. In the US it is considered outpatient and you don't stay in hospital. Here they said I should stay for two nights. In my opinion first night was indeed needed but second was unnecessary so for the second one I asked if I could leave after the first night and they said I could if I feel good enough, which I did.

Basically I think you should talk to your doctor and if you know someone who has had a similar surgery, you may take their opinion, though things always change from person to person.

Also if you decide to go home, make sure you have somebody next to you just in case...
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Old 22.02.2015, 15:17
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Re: Hospital stay for straightforward surgery?

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If you mean herniated disc (bandscheibenvorfall) in your back you could stay in hospital for a week. If you mean a normal hernia ( leistenbruch)
Then it's max 2 nights, but usually you may go the next day...
Oh how this made me smile. I've had the disc surgery twice (in the U.S.) and both times I was in hospital for only one night. If the surgery goes well, you can stand up and walk and you're not dying, the mantra there is "suck it up, sister" and you're out the door the next day.

However I'm guessing since OP stated it's a keyhole procedure he/she means a normal hernia.
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Old 03.06.2015, 20:04
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Re: Hospital stay for straightforward surgery?

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Hello,

I'm due to have surgery in a few weeks for a hernia. It's a very common procedure (keyhole) and only takes about 30 minutes though it will be done under general anesthetic.

The strange thing is that my surgeon says I'll need to stay in hospital for two nights. Everything I've read about the procedure elsewhere (e.g. US, UK, Scandinavian health authorities) says that the surgery is straightforward and normally done on an outpatient basis so you go home the same day.

I haven't been in Switzerland long so I'm wondering if this kind of precautionary approach is typical here, or if it's just so they can charge more money. I've no desire to stay in hospital if it's not necessary. And I can think of no health reasons for keeping me in.

I'm going to ask the surgeon at my pre-op consultation in a week's time but just wondering if anyone has had any similar experiences.

Thanks!
I'm guessing they do this for the money.

I had surgery two weeks ago and same thing. The problem with the general ward is that you can't sleep without sleeping aids due to all the commotion. I don't want to be on sleeping aids for four days, that's just nuts! I also don't want to eat the food in the hospital because it's terrible and the constant vomiting doesn't help with the healing process.

The other issue is that a lot of lonely old people seem to enjoy the hospital and if you end up with one as a roommate, well, it's somewhat hellish.

I went home the second I had a set of internal stitches removed. If I had to do it again, I would have insisted on going home right after the surgery and return for the stitches to be removed two days later via taxi. It certainly would have been cheaper than the semi-private room with the chatty katty that wouldn't shut up for 10 minutes.
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Old 03.06.2015, 20:21
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Re: Hospital stay for straightforward surgery?

Not my experience at all at our Fribourg cantonal hospital. Didn't have any trouble sleeping and the food is excellent, nice choice of menus and different every day.

It always amazes me when we go there for appointments, etc, that it's more like walking down the corridors of an hotel than a hospital, it's so quiet and so few people about. Real contrast to our local UK one.
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Old 04.06.2015, 02:59
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Re: Hospital stay for straightforward surgery?

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Not my experience at all at our Fribourg cantonal hospital. Didn't have any trouble sleeping and the food is excellent, nice choice of menus and different every day.

It always amazes me when we go there for appointments, etc, that it's more like walking down the corridors of an hotel than a hospital, it's so quiet and so few people about. Real contrast to our local UK one.
Then maybe the staff at this hospital do not try to make things quiet and conducive for healing. It was truly a terrible experience. I barely slept for two days after surgery, got home and promptly fell asleep for 6 hours in the middle of the afternoon, then another 8 overnight. I didn't even miss the morphine.
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Old 04.06.2015, 03:07
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Re: Hospital stay for straightforward surgery?

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Not my experience at all at our Fribourg cantonal hospital. Didn't have any trouble sleeping and the food is excellent, nice choice of menus and different every day.

I guess it depends a lot on how easily you can sleep. I usually fall asleep easily but any noise is likely to wake me up... So I could not sleep after either of my surgeries in two persons room in a private hospital and was looking fwd very much to get home as soon as possible despite doctor's advise to stay longer, though sleeping was not the only factor.
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