One hospital's waiting lists for hip and knee surgery could be cut in half within a year, according to doctors.
More patients can now be sent home the same day after surgeries at the Princess of Wales hospital in Bridgend.
The lack of hospital beds is therefore not an obstacle for them.
This news comes as over 37,000 orthopaedic patients in Wales have been waiting more than a year for surgery.
The procedure underwent a number of "minor tweaks," according to consultant orthopaedic surgeon Keshav Singhal, "but all of them add up to a huge effect.".
According to him, the anesthetic and painkillers given to patients are "fine-tuned" to lessen discomfort and motion sickness after the procedure, and extra time is spent locating and cauterizing any potential bleeding areas to "prevent wound leakage.".
There are no beds here, so in day surgery we are not limited by them, said Mr. Singhal.
"Patients can come in, receive excellent care in a state-of-the-art day surgery unit, and leave in the evening, completely reducing the need for inpatient beds," the doctor said.
Former pub owner Cheron White, 68, recently benefited from the new system for Cwm Taf Morgannwg health board eligible patients.
The Porthcawl mother of five explained that it frees up beds for those who truly need them.
I'm not sick; this is just an operation. Why should I stay in the hospital if I'm not sick?
The day after her surgery, Ms. White said: "I want to be as mobile as possible, to kind of thank the hospital for giving me this opportunity to be mobile.
"It was awful just sitting there, aging and not being able to do things; it was making me feel older, even though I know I'm not old.
According to Mr. Singhal, the insufficient hospital space has acted as a catalyst for innovation in orthopaedic surgery.
In the past, recovering from a joint replacement might have required several days in the hospital; however, there are currently fewer beds available in Wales as about 1,000 patients a month cannot be discharged due to a lack of social care.
Currently, there are 37,396 people in Wales who are waiting longer than a year for trauma and orthopedic surgery, with more than a third of them waiting longer than two years.
Day surgery, according to Mr. Singhal, is only appropriate for patients who are generally healthy, have the drive to complete the rehabilitation exercises, and have family support.
He clarified that it's essential to reassure patients and make them aware of what will happen.
"The patients are concerned: if I move too quickly, will I damage my joint, and if I move, will I hurt myself more?
Their motivation increases once we reassure them on these two points and make sure the pain is under control.
They are aware that a faster recovery and a decreased risk of deep vein thrombosis can be achieved by moving more quickly.
Day-surgery joint replacements are not uncommon, but thanks to the changes made, the hospital was able to formally establish this alternative path for some patients.
As a result, space on other surgical waiting lists becomes available for patients with more complicated needs who will need a bed in a ward.
The lack of inpatient beds, according to Mr. Singhal, "was unquestionably the catalyst.".
"Covid caused a complete restructuring of our services, so we had to make sure that we could continue these operations in the absence of beds. The best route was this one.
"We anticipate that implementing this policy across the board would significantly reduce the waiting times that are currently experienced in Wales and the rest of the UK.
Dr. Gareth Parry, an anesthetist who is also a part of the new system, claimed that the improvements made have improved the situation for patients.
Nearly 20% of patients reported feeling quite ill after surgery, which decreased to being something that was relatively uncommon, he said.
Wales had 748,271 patient pathways awaiting treatment as of November, which is equivalent to approximately 586,000 distinct patients because some patients will be on multiple "pathways" to treatment.
According to Mr. Singhal, day surgery for joint replacement has been practiced for a number of years in America and in a few hospitals in England, but he thinks they are the first to organize it in Wales.
