One-day surgery for children

Published: 12. 7. 2021
Author: Redakce
Photo: Foto Shutterstock.com a/and Canadian Medical
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Planned surgical procedures usually follow a similar course in most children's surgical units: the young patient is admitted on one day, the procedure happens the following one, and the child is released only on the third or fourth day. Things do not have to be this way, however. In healthcare facilities specialized in emergency and one-day surgery, procedures like these (in case of less complicated surgeries, of course) can be handled in a single day. This also helps lower the risk of the child's infection to a minimum.

Everything heals better at home

“Being hospitalized is more stressful to child patients than the surgical procedure itself,” points out Libor Janeček, M.D., who is a respected name in the field of paediatric surgery thanks to his more than twenty-five years of practice. Let's not delude ourselves, a stay in even the best of hospitals is a rather unpleasant and stressful experience for children. Even if they have a parent with them (which is not always the case), they are forced to stay in an unknown environment, follow the hospital rules, and are scared and bored. And that is not all. Historically, it was believed that the child is at a lower risk of infection in a hospital than at home. It has come to light that the opposite is true, in fact. Children are mostly used to the microbiological make-up of their homes and have the appropriate antibodies. They are in much less danger of infection there than in a hospital to which their immune system has not had time to adapt. Hospital environments also have a much higher concentration of nosocomial (hospital) bacteria due to the presence of patients with a variety of issues. There are dangers of staphylococcal or streptococcal infections, for instance.

Parents and doctor – a well-oiled machine

Procedures that are less technically demanding, shorter, and less invasive (which is the majority of surgeries at a young age), can be handled without long periods of hospitalisation with comparable results. “Children who come to the Canadian Medical clinic in Jinonice's Waltrovka residence, are very quickly admitted to the operating room and are usually released within two hours of the surgery itself. In more complicated procedures – such as laparoscopy – they go home after 24 hours, meaning one overnight stay. The child is only released into home care once they are completely out of danger of any postoperative complications. Naturally, we are in regular contact with the parents to monitor the postoperative condition of the young patient,” says Libor Janeček.

Such surgeries, however, require a perfect understanding between the surgeon and the parents. “The parent has to agree to the given type of procedure and be willing to take a part of the responsibility on themselves, especially in adhering to postoperative recommendations. This does not seem to be an issue, though, as nobody provides their child with better care and supervision than their mother,” he adds. To ensure the absolute safety of the patient, the surgeon is available around the clock on their phone. “The parent needs to know that their doctor is available if the need arises,“ points out Dr. Janeček.

Basic rules

“In case of any issues – even if they are just having doubts – the parents will call me. Most of the time, all they need is the reassurance and explanation that the condition is in line with possible postoperative developments. Any findings can be sent as a picture or a video, and subsequently consulted,“ explains Dr. Janeček. In very rare cases, there comes a need to meet in person, and there are contracted facilities for just such cases that operate around the clock (mostly general hospitals). The option to have emergency surgery without hospitalisation is partly limited by age – it is generally for patients aged two years or older. “However, thanks to Associate Professor Mixa, our experienced anesthesiologist, we can operate on children as young as 10 months in our Waltrovka facility,“ Libor Janeček points out. Pre-operative assessment is conducted by the admitting paediatrician, who also makes sure that there are no dangerous conditions or diseases that could put a stop to the surgery.

Ideal for laparoscopy

The one-day surgery model is ideal for laparoscopic procedures – at a young age these are mostly appendectomies, gallbladder surgeries, or varicocelectomies (removal of enlarged testicular vein formations – varicoceles). Diagnostic laparoscopy for chronic stomach pains is also a useful tool. Emergency surgery is a solution to all kinds of hernias (umbilical, femoral, ventral, etc.), hydrocele hernias, undescended testicles. It also allows for any procedures on the foreskin, birthmark and wart removal, and even ingrown nail operations. Such procedures should only be conducted in facilities specialized in emergency and one-day surgery that have the necessary technologies and staff (especially an experienced anesthesiologist and paediatric surgeon).


Libor Janeček, M.D., has been working with young patients (from birth until 19 years of age) most of his career. He specialises in outpatient procedures. He is the chief paediatric surgeon of Canadian Medical.

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