Outpatient Operations
1. General information:
The term "outpatient surgery" means that the patient appears on the planned surgery day and is not hospitalized - he or she can leave the clinic on the same day. The short hospital stay allows the patient to recover in familiar surroundings.
The prerequisites for the feasibility of an outpatient surgery are:
- The patient does not have an increased risk of narcosis / surgery (see above).
- The risk of complication after discharge must be reasonably low (see below).
- An accompanying person is available for the day of the operation, who can look after the patient.
Of course, the high quality standards that are placed on the performance of surgeries in Germany also apply to outpatient procedures - only specialist doctors who have the necessary experience and knowledge regarding the planned procedure operate. The following medical care is usually guaranteed in the referral specialist practice or in special cases, in our Polyclinic.
2. List of outpatient procedures:
Ear:
- Insertion or removal of a tympanic drainage
- Ear plucking, in adolescents and adults also with local anesthesia. The reimbursement must have been previously approved by the health insurer. The domestic conditions must allow recovery without complications.
- Sampling from the ear canal
- Tympanic splint in traumatic, non-marginal eardrum defect
- Local skin tumor removals
- Local skin sculptures
Nose and sinuses:
- Foreign body removal
- Removal of isolated nasal polyps
- Nasal bone straightening
- Trial excision from the main nasal cavity
- Nasal concha reduction (only caustics)
- Metal removal after surgical treatment of facial bone fractures
Mouth, throat:
- Removal of the tonsils in children (adenotomy), the clinic must be reachable within 30 minutes by car
- Rigid esophagoscopy for foreign body removal (without complications)
- Small trial excision from the mouth / pharynx
- LASER surgical excision of small tumors of the tongue and oral mucosa
Skin and neck:
- Removal of smaller skin tumors and their plastic coverage
- Smaller scar corrections
- Removal of Atheroma in the Inflammatory Interval
- Change of voice prostheses
3. Which patient is suitable for outpatient surgery?
If the required operation can be performed on an outpatient basis (see above), the patient's state of health is decisive - this is assessed by the physician in the polyclinic:
- The patient must be reachable/have access to telephone in order to report any problems after the operation
- Before the planned procedure, the attending physician will conduct an informative discussion in addition to the medical history and examination, explaining the surgical procedure.
In order for the patient to be able to agree to the planned procedure, a good linguistic understanding with the doctor is indispensable. If the patient or his responsible companion does not speak the German language well, we ask that you be accompanied by an interpreter (such as a family member or friend).
- On the Op-day, a home care must be guaranteed until the next morning. Strenuous activities should not be performed. They should be handled by family, friends or hired help (for example, household or child care). It is advised that the caregiver picks up the patient in the hospital, so that in individual cases, personal instructions can be given. Alternatively, the way home is possible by taxi.
- Our clinic should be accessible within 30 minutes, so that an emergency care is possible for the extremely rare case of late complications. The telephone number of the primary care service and our clinic should be accessible.
4. Types of ambulatory anesthetic form:
Local Anesthesia: Here, a locally effective anesthetic is applied into the skin and thereby the area of intervention is insensitive to pain. The patient remains awake and responsive. In very anxious people, a so-called. Intravenous analgesic sedation can be administered in addition; i.e. You are in a kind of twilight sleep, but remain responsive.
General anesthesia: The patient is unconscious by intravenous medication for the duration of the procedure. Thanks to modern medication, this form of anesthesia can be controlled very safely so that you only have to retake a few minutes. The patient can usually be discharged on the day of surgery.
Important:
An absolute prerequisite for general anesthesia is sobriety! The patient's last meal should be 6 hour before surgery. (No chewing gum!) Absolutetly no alcohol, no liquids, or smoking of any kind is allowed, otherwise serious complications can occur during anesthesia!
Important medications may be taken after consultation with the anesthetists on the morning of the operating day with a sip of water. Exceptions to this are anticoagulant drugs such as:
- Acetylsalicylic acid - it is included in many flu remedies (eg Aspirin®, Spalt®)!
- Clopidogrel
- Marcumar
- As well as certain diabetes medicines in tablet form (for example metformin)!
- These drugs must not be discontinued independently! Please consult your family doctor first! Some patients may need to switch to another medication.
5. Process of Planning an Outpatient Operation:
- We need a referral from the referring ENT specialist - and the health insurance card. This must also be brought on the surgery day.
- The patient is first examined by a doctor at the first contact in the ENT Polyclinic. If the decision follows an outpatient procedure, the operation is discussed with the patient (OP consent).
- Subsequently, the surgery appointment can be made at the front desk of the Polyclinic.
- In the case of planned general anesthesia, the patient is presented to the anesthetist either on the same day or one day before the scheduled surgery. If preliminary examinations are necessary for the anesthesia, these will be organized by our team.
- On the day of surgery, the patient will arrive at a previously assigned ward and be prepared for intervention by nurses.
- For some cosmetic surgeries (for example, auricular plastic surgery), a written confirmation of reimbursement by the health insurance company is required before the surgery date.
- If necessary, the clinic issues a certificate of incapacity for work or other attestation to the carer or employer on the day of the visit.
- To avoid pain after surgery, the patient receives painkillers for the surgery day - if necessary, we will issue you a prescription for the following day.
- For children over 2 years, the registration takes place directly on the children's ward (ENT I). Here you will get an appointment for the first presentation. As a rule, the operation takes place on the following day.
6. Appointment:
The date of the procedure is given by the Polyclinic. However, an exact time for the OP can only be estimated. Possible waiting period at the ward is to be expected.
7. Place of operation:
The patient arrives at the agreed time in the Polyclinic for registration.
The outpatient operations take place in our operating room. The patient will be called 15-30 min. to the station before the scheduled appointment. Children can be accompanied by their parents to the operating room entrance. Accompanying the child into the operating room is generally not possible.
8. Date of discharge:
After the surgery, the surgeon and, if necessary, anesthetist will explain the course of the operation and further instructions to the patient will be given. Discharge time is also determined jointly by the two doctors. As a rule, after general anesthesia, discharge is possible in the late afternoon.
After a procedure under local anesthesia, the patient can leave the clinic after approximately 30 minutes of rest and observation on the ward.
9. Escorts:
For all outpatient operations (general anesthesia / local anesthesia) the following applies: On the day of the operation, the patient is not safe to be driving/on the road!
Since circulatory problems or rebleeding may (very rarel)y occur postoperatively, the patient should not come alone on the day of the operation and an accompanying person should be present.
10. Conduct after the procedure:
The patient is usually not bedridden after the procedure.
However, strenuous physical effort should be avoided as complications such as counteract bleeding can occur.
On the day of the procedure, absolutely no alcohol is allowed as incalculable drug interactions may occur.
Questions about special body care in relation to the Op-field or dressing change are discussed individually between patient and surgeon.
If urgent questions arise at home, the hospital's ENT specialist can be reached at any time by calling 0049 - (0) 391-6713810 or 0049 - (0) 391-6713820 or 0049 - (0) 391-6713830.
11. Possible complications at home:
In principle, only such interventions are carried out on an outpatient basis, which can usually lead to non-threatening complications.
Light rebleeding in the wound area is rare and generally normal, as are postoperative pain conditions. In people who are sensitive to circulation, short-term circulatory reactions may also occur later after general anesthesia, although they can usually be treated successfully immediately by lying flat. Prevention should be taken after surgery-plenty of fluid and a minimum of food.
12. Medical care after the operation:
Depending on the procedure, most wound dressings can be performed by the referring specialist until complete healing. If you have any questions, our surgeons are also available by telephone. In some cases, a check up is carried out in our polyclinic; The patient is informed of this by the surgeon before being released.