Clinic for Surgery

We are constantly on the lookout for improvements for our patients. This is also reflected in the multimodal standardised treatment concept Enhanced Recovery After Surgery (ERAS). In German, this means "enhanced recovery after surgery". ERAS stands for gentle treatment during surgical procedures and for your optimum post-operative recovery. It is based on international scientific findings for optimal patient care. The Clinic for Surgery at Zollikerberg Hospital has been ERAS-certified since 4 April 2023.

ERAS certification

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Your active contribution

An interdisciplinary team consisting of surgeons, anaesthetists, nurses, nutritional therapists and physiotherapists work hand in hand to ensure a speedy recovery after the surgical procedure. However, you play the most important role in this team. You can actively contribute to your recovery in various phases. Among other things, you will receive a diary on admission to hospital. This enables you to document the recovery process and optimise it on an ongoing basis. You can find out more about this in the section "Course of your treatment".

ERAS patient diary

Aims of the ERAS treatment concept

Rapid and optimal recovery after the surgical procedure
Minimisation of possible complications
Rapid return to your normal everyday life

In the following brochure you will find all the details about the ERAS treatment concept.

ERAS treatment brochure

Advantages of the ERAS treatment concept

Gentle surgical technique
Less pain and nausea
Rapid intake of food and fluids
Fewer complications
Earlier discharge from hospital possible
Personalised pre- and post-operative care

Course of your treatment

Physical activity

Stay physically active. Do your usual sporting activities. Daily walks of 15 minutes can help to keep you fit until the operation. In the exercise flyer provided, you can see which exercises you can start immediately after the operation. It is best to try these out at home beforehand.

Smoking

Stop smoking four weeks before the operation. This reduces the risk of lung complications and wound healing disorders.

Alcohol consumption

Do not drink alcohol. Please let us know if you need help to reduce your alcohol consumption.

Nutrition

Eat a balanced diet. Make sure that you eat a protein-rich component such as meat, fish, eggs, cheese, etc. with every main meal and combine it with a starchy side dish such as potatoes, rice, pasta, etc. You may also eat and drink normally on the day before the operation. If your nutritional status requires it, we will make an appointment for you with a nutritional counsellor.

Planning your hospital discharge in advance

Plan ahead. Prepare for your return home after the operation. You may need help from your family, friends or Spitex with shopping, housework or the bathroom.

Laxatives

As a rule, laxatives are not necessary before the operation. However, if this is necessary for you, you will receive separate instructions.

Evening and morning of the day of the operation

You will be given four packs of a carbohydrate-rich drinkable food (Nutricia PreOP) the evening before the operation and two packs on the day of the operation. This supports your recovery after the operation.

Health insurance card
Copy of the identity card
Copy of the living will (if available)
Own medication in original packaging and any dosage card
Personal aids such as glasses, contact lenses, hearing aids
Any walking aids
Toiletries (toothbrush, toothpaste, hairbrush, shaving kit, deodorant)
Comfortable clothing (pyjamas, tracksuit, dressing gown)
Slippers and sturdy shoes
No valuables, jewellery and/or credit cards

The anaesthetist will have informed you when you must stop eating and drinking before the operation. You must refrain from smoking.

For the operation, please remove all jewellery and put on your hospital gown. You will be given support stockings to prevent thrombosis (reducing the risk of blood clots forming). Please also wear these for the first few days after the operation.

After the operation, you will first be cared for in the recovery room or in the intensive care unit. Later, the nurse in charge will take you back to your room. As mobilisation as soon as possible is important for the recovery process, you will get up again on the day of the operation. The nursing staff will help you with this.

You will be allowed to eat and drink a few hours after the operation.

Tubes are usually still attached to your body. For example, an infusion to regulate fluids and a bladder catheter to drain urine, sometimes also a pain catheter (peridural catheter/PDA) on your back, and you may be given oxygen via your nose. These tubes will initially restrict your freedom of movement somewhat. However, you should still move around. The nursing staff will be happy to help you with this.

Your personal diary

You will receive this on admission. It enables you to actively help shape and document the recovery process. Set yourself a new goal for the next day every evening. You can download and view the diary above.

Physical activity - mobilisation

Exercise after the operation reduces complications, stimulates the circulation, aids digestion and reduces the loss of muscle mass. The nursing staff will therefore help you to get up shortly after the operation. You will find additional exercises in the exercise flyer provided. It is important to stay out of bed as much as possible. Wear your own clothes, sit at the table to eat, read in an armchair, go for a walk in the corridor or take a trip to the cafeteria or the park. In this way, you can make an active contribution to your recovery.

Gastrointestinal activity

You may suffer from nausea or have a reduced appetite after your operation. If you feel nauseous or need to vomit, please contact the nursing staff. Physical activity promotes the natural movements of the bowel and thus digestion. Chewing gum and drinking sufficient fluids also stimulate gastrointestinal activity.

Eating and drinking

Unless otherwise agreed, you do not need a special diet after the operation. Eat slowly and drink enough. Take a break if you feel nauseous. Anything that tastes good and is well tolerated is permitted. We will also serve you an energy and protein-rich drink to support your nutrient intake.

Pain therapy

Wound pain after the operation is normal. It can be treated well with various painkillers. You should not have to endure any pain so that you can move normally again soon after the operation. Please let us know if your pain treatment is inadequate. Reserve medication is always prescribed and there is always a doctor in the clinic who can optimise your pain treatment if necessary.

Once your body has regained normal functions such as eating and digestion, the surgical wounds are healing well and the pain can be sufficiently alleviated with painkillers, the nursing team will organise your discharge from hospital. This is usually the case after four to six days.

We will explain to you how to take the pain medication and how to reduce it in due course. In some cases, injections to prevent thrombosis may also be necessary after hospitalisation. The nursing staff will instruct you in detail on how to inject the blood thinner yourself. If you wish, Spitex can also do this for you. We will be happy to help you with the organisation. We will also explain to you how to care for the surgical wounds.

You will receive a discharge report, a prescription for medication and a follow-up appointment with your surgeon.

Nutrition

You can eat and drink as usual. It is normal if you have little appetite in the first few days. Make sure that you drink two litres of unsweetened drinks. Even when you are back at home, we will be there for you if you have any questions or problems. If the diet is a problem for you or if you continue to lose weight, please contact us.

Digestion

It is possible that you will have irregular bowel movements in the first period after the operation. Constipation and diarrhoea may alternate. This should normalise in the first few weeks after the operation; regular bowel movements are important. If you suffer from constipation, we recommend taking a mild laxative.

Physical activity, exercise and sport

It is normal for you to have less energy than usual in the first few weeks after the operation and to feel tired more often. However, it is important that you are still active at home and go for walks, for example. You can move around freely. However, avoid movements that cause pain in order to protect the wounds on the abdominal wall.

Pain medication

Abdominal pain is normal after bowel surgery. You have been given a prescription for painkillers so that you can cope with everyday life with as little pain as possible. You are best placed to judge when it is possible to reduce the painkillers and you can stop taking them yourself. We recommend that you do this in stages and not stop taking all the medication at once.

Wound care

The surgical suture is usually covered with a plaster bandage, which can be removed after seven to ten days. Wound infections can also occur after leaving hospital. The first signs of this may be pain, redness, overheating or the discharge of fluid from the wound. In this case, please contact us.

Bathing

You can shower as usual and bathe or go to the sauna again one day after the stitches have been removed, once the wound is completely closed.

Working

The duration of your incapacity for work will be discussed with you. It will depend on the type of operation and your occupation.

Follow-up appointments

Make an appointment with your family doctor seven to ten days after the operation to check the wound. He or she can also remove any skin staples or stitches.

In the first week after leaving hospital, the ERAS nurse will call you to enquire how you are feeling.

A few weeks after discharge, an appointment will be made with your surgeon for a final check-up.