Establishing a day case lumbar microdiscectomy service at a University Hospital in Dublin, Ireland

BACKGROUND: Day case surgery offers significant patient and economic benefits, with 75% of elective surgeries targeted to be performed as day procedures as set by the Association of Anaesthetists. While advances in surgical and anaesthetic techniques have made more complex surgeries feasible as day cases, concerns remain about the safety of day case spine surgeries due to potential severe complications. OBJECTIVE: This observational study evaluates the feasibility and safety of day case lumbar microdiscectomy (DLM) in an Irish university hospital setting by comparing discharge rates, readmission rates, and patient satisfaction with international data. RESULTS: Of the 26 patients who underwent surgery, 24 (92.3%) were successfully discharged on the same day. No patients required readmission within six weeks postoperatively. High levels of patient satisfaction were noted and similar outcomes to those reported internationally. ANALYSIS: Key factors for success included the development of standardised intraoperative protocols, the use of multimodal analgesia, and strict patient selection criteria. Challenges in implementing take-home analgesia protocols were noted, emphasising the importance of dedicated staff and frequent education to maintain protocol adherence. CONCLUSION: The study concludes that DLM is a viable, safe, and cost-effective option for selected patients, with potential savings of €1660 per patient compared to traditional inpatient procedures. These findings support the feasibility of DLM in Ireland.