What is outpatient surgery. How does it differ from inpatient procedures. What types of anesthesia are used in outpatient surgeries. How should patients prepare for same-day surgical procedures. What are the benefits and considerations of ambulatory surgery.

The Rise of Outpatient Surgery: Revolutionizing Modern Healthcare

Outpatient surgery, also known as same-day, ambulatory, or office-based surgery, has become increasingly prevalent in recent years. According to the Centers for Disease Control and Prevention, nearly two-thirds of all operations are now performed in outpatient facilities. This shift represents a significant transformation in the healthcare landscape, offering patients numerous benefits while maintaining high standards of care.

These procedures can be performed in various settings, including facilities connected to hospitals, standalone surgical centers, or even physicians’ offices. The primary advantage of outpatient surgery is that it allows patients to recover in the comfort of their own homes, often resulting in lower costs and potentially reduced risk of infection.

Key Advantages of Outpatient Surgery

• Convenience of recovering at home
• Potentially lower costs compared to inpatient procedures
• Reduced risk of hospital-acquired infections
• Faster return to normal activities
• Less disruption to daily routines

Understanding the Scope of Outpatient Surgical Procedures

Outpatient surgeries can range from simple, quick procedures to more complex operations that may take several hours. These procedures are typically planned in advance and are not usually performed for medical emergencies. The complexity and duration of outpatient surgeries have expanded over the years due to advancements in medical technology and anesthesia techniques.

Common Outpatient Surgical Procedures

• Mole removal
• Hernia repair
• Knee replacement
• Cataract surgery
• Colonoscopy
• Arthroscopic procedures
• Dental surgeries
• Cosmetic procedures

Can major surgeries be performed as outpatient procedures? Yes, with advancements in surgical techniques and anesthesia, even more complex surgeries like total joint replacements are now being performed in outpatient settings for carefully selected patients.

Anesthesia Options for Outpatient Surgery: Ensuring Comfort and Safety

Regardless of where the surgery is performed, patients will receive some form of anesthesia or medication to prevent pain during the procedure. The type of anesthesia used depends on various factors, including the nature of the surgery, the patient’s medical history, and the preferences of both the patient and the surgical team.

The Four Main Types of Anesthesia in Outpatient Surgery

1. General Anesthesia: Administered through a mask or IV, causing unconsciousness during the procedure. Typically used for major operations like joint replacements.
2. Regional Anesthesia: Delivered via injection or catheter, numbing a large area of the body. Common for procedures such as childbirth or surgeries on the abdomen, arms, or legs.
3. Monitored Anesthesia Care (MAC) or IV Sedation: Medication administered through an IV to induce relaxation or sleepiness. Often used for minimally invasive procedures like colonoscopies.
4. Local Anesthetic: A one-time injection that numbs a small area, suitable for minor procedures like skin biopsies or stitching cuts.

How is the appropriate type of anesthesia determined for each patient? The choice of anesthesia is a collaborative decision made by the surgical team, taking into account the patient’s medical history, the nature of the procedure, and the patient’s preferences. An anesthesiologist, a medical doctor specializing in anesthesia care, will discuss the options with the patient before surgery to ensure a safe and comfortable experience.

Preparing for Outpatient Surgery: Essential Steps for a Successful Procedure

Proper preparation is crucial for the success and safety of any surgical procedure, including outpatient surgeries. The specific instructions may vary depending on the type of surgery and anesthesia being used, but there are general guidelines that apply to most cases.

Key Preparation Steps for Outpatient Surgery

• Follow fasting instructions if receiving sedation or general anesthesia
• Arrange for a friend or family member to accompany you
• Wear comfortable, loose-fitting clothing
• Plan for adequate recovery time at home
• Prepare for potential side effects and pain management

Why is it important to have someone accompany you for outpatient surgery? Having a companion is crucial for several reasons: they can provide emotional support, help you remember post-operative instructions, and assist you in getting home safely, as you may not be able to drive after receiving certain types of anesthesia.

Recovery and Post-Operative Care: Ensuring a Smooth Healing Process

The recovery process following outpatient surgery varies depending on the procedure and type of anesthesia used. While patients can return home on the same day, it’s essential to follow post-operative instructions carefully to ensure proper healing and minimize complications.

Post-Operative Considerations

• Arrange for someone to stay with you for at least 24 hours after surgery
• Expect some soreness and potential drowsiness
• Be aware that anesthesia may affect reflexes and judgment temporarily
• Follow pain management instructions provided by your surgeon or anesthesiologist
• Attend follow-up appointments as scheduled

How long does it typically take to recover from outpatient surgery? Recovery time varies greatly depending on the procedure and individual factors. Some patients may feel back to normal within a day or two, while others might require several weeks of recuperation. It’s important to follow your healthcare provider’s guidance and not rush the healing process.

The Role of Technology in Advancing Outpatient Surgery

Technological advancements have played a significant role in the expansion of outpatient surgical procedures. Minimally invasive techniques, robotic-assisted surgeries, and improved imaging technologies have all contributed to making more complex procedures feasible in ambulatory settings.

Technological Innovations in Outpatient Surgery

• Laparoscopic and endoscopic techniques
• Robotic-assisted surgical systems
• Advanced imaging and navigation technologies
• Improved anesthesia monitoring systems
• Enhanced pain management techniques

How has technology improved patient outcomes in outpatient surgery? Technological advancements have led to smaller incisions, reduced blood loss, faster recovery times, and improved precision in surgical procedures. This has expanded the range of surgeries that can be performed safely in outpatient settings and has generally improved patient experiences and outcomes.

Economic Impact and Healthcare System Benefits of Outpatient Surgery

The shift towards outpatient surgery has had a significant impact on healthcare economics and system efficiency. By reducing the need for overnight hospital stays, outpatient procedures can lead to cost savings for both patients and healthcare providers.

Economic and Systemic Advantages

• Reduced healthcare costs for patients and insurers
• Increased hospital bed availability for more critical cases
• Improved efficiency in healthcare resource allocation
• Potential for higher patient satisfaction due to faster recovery at home
• Reduced burden on hospital staff and resources

What impact has the growth of outpatient surgery had on healthcare costs? The shift towards outpatient procedures has generally led to lower overall healthcare costs. Ambulatory surgeries typically have lower facility fees, reduced staffing requirements, and eliminate expenses associated with overnight hospital stays. However, it’s important to note that the cost savings can vary depending on the specific procedure and individual circumstances.

Patient Selection and Safety Considerations for Outpatient Surgery

While outpatient surgery offers many benefits, it’s not suitable for every patient or procedure. Careful patient selection is crucial to ensure safety and optimal outcomes. Healthcare providers consider various factors when determining if a patient is a good candidate for ambulatory surgery.

Factors Considered in Patient Selection

• Overall health status and medical history
• Age and physical fitness
• Complexity and duration of the planned procedure
• Potential for complications
• Availability of post-operative support at home
• Distance from the surgical facility to the patient’s home

What safety protocols are in place for outpatient surgical facilities? Outpatient surgical centers are required to meet strict safety standards and regulations. These include proper staffing with qualified healthcare professionals, appropriate emergency equipment and protocols, strict infection control measures, and regular quality assessments. Many outpatient facilities are accredited by organizations such as the Accreditation Association for Ambulatory Health Care (AAAHC) or the Joint Commission, ensuring they meet high standards of patient care and safety.

As outpatient surgery continues to evolve and expand, it’s reshaping the landscape of modern healthcare. By offering patients the opportunity to undergo a wide range of procedures with minimal disruption to their daily lives, ambulatory surgery centers are playing an increasingly important role in delivering efficient, effective, and patient-centered care. However, it’s crucial for patients to thoroughly discuss their options with their healthcare providers to determine if outpatient surgery is the best choice for their individual needs and circumstances.

Outpatient Surgery – Definition & Types

Outpatient Surgery

Packing a bag for a night or two in the hospital might not be on your to-do list if you’re preparing for surgery. Today nearly two-thirds of all operations are performed in outpatient facilities, according to the Centers for Disease Control and Prevention. Your surgery might be performed in a facility connected to a hospital, a separate surgical center or your physician’s office. Outpatient surgery, also called same-day, ambulatory, or office-based surgery, provides patients with the convenience and comfort of recovering at home, and can cost less. It might also help lower your risk of infection.

Wherever your surgery is performed, you will be given some form of anesthesia or medication to keep you from feeling pain during the procedure.

Outpatient surgeries can take a few minutes or a few hours, and most are not for medical emergencies. A typical outpatient surgery might be a simple mole removal, a hernia repair, or a knee replacement.

What types of anesthesia are available?

Wherever your surgery is performed, you will be given some form of anesthesia or medication to keep you from feeling pain during the procedure. There are four main types of anesthesia used in outpatient surgery. You and your surgeon or anesthesiologist, a medical doctor who specializes in anesthesia care, will discuss this with you before your surgery so you will know what to expect and can prepare for a safe and comfortable experience.

The four types of anesthesia:

• General anesthesia. This type of anesthesia is given through a mask or IV and causes you to become unconscious during the procedure. General anesthesia is typically used for major procedures such as knee or hip replacements.
• Regional anesthesia. Regional anesthesia is usually given through an injection or a thin tube called a catheter, often in the spine. It numbs a larger part of the body than local anesthetic does, such as your body from the waist down. It is often used for procedures such as childbirth, or surgeries of the abdomen, arm, or leg. You will be awake but won’t feel pain in the area that is numbed.
• Monitored anesthesia care or (IV) sedation. You may be given medication that relaxes you or makes you sleepy through an IV into a vein. There are several levels of sedation, and people react differently to them. Some people are awake and can talk but feel no pain. Others fall into a deep sleep and remember nothing of the procedure. This type of anesthesia is often used for minimally invasive procedures such as colonoscopies. Sedation sometimes is combined with local anesthetic.
• Local anesthetic. This is usually a one-time injection of medicine that numbs a small area for procedures such as a taking a skin biopsy, repairing a broken bone, or stitching a deep cut. You will be awake and alert but won’t feel pain in the area being treated.

Your physician will give specific instructions on how to prepare the night before and the day of your surgery to help ensure a safe and successful experience.

How should you prepare for outpatient surgery?

Just like for inpatient surgery in a hospital, there are instructions to follow to prepare for your outpatient surgery. Your preparation will depend in part on the type of anesthesia you will be having. If you are having sedation or general anesthesia, you may be told not to eat or drink anything for several hours before your procedure. This is usually not necessary for minor procedures requiring only local anesthesia.

Other preparations that will help ensure a safe and comfortable procedure include the following:

• Bring a friend or family member. If you are having anesthesia that puts you to sleep or sedates you, you won’t be able to drive or get home on your own. Having someone with you will also help you relax before your procedure and will help you remember the instructions for your recovery.
• Wear comfortable clothing. You may be sore from the surgery or have bandages that cover incisions, so wear loose and comfortable clothes.
• Plan for recovery time. If you’ve had a minor surgery with local anesthetic, you may be able to go home very soon after your procedure. If you have regional anesthesia, sedation or general anesthesia, the anesthesiologist may monitor you for a few hours to make sure your heart and breathing are normal and you aren’t experiencing side effects. Once you’re home, it’s a good idea to have someone stay with you for at least the first 24 hours. You will probably have some soreness and may be sleepy. The anesthesia also may affect your reflexes and judgment for a while, so plan to stay home and rest.
• Be prepared for side effects. Ask your anesthesiologist or surgeon what type of pain or soreness to expect and how best to treat it. Anesthesiologists are specialists in controlling pain and can advise you on prescription and over-the-counter medications, as well as ways to manage pain without drugs. The anesthesiologist can also help if you have nausea or vomiting, which some patients experience for a few hours or days after surgery and anesthesia.

What should you know about the facility and physicians?

Although outpatient surgeries may not be for medical emergencies and are often less complex than surgeries requiring an overnight hospital stay, it’s still important to do your homework to make sure you’re getting the best care.

Here are some questions to ask:

• What are the qualifications of the surgeon and other medical staff? Ask about the qualifications and experience of the physician leading your care to make sure he or she is certified to perform the procedure. Those who are qualified have special training and have passed exams given by a national board of surgeons. Also ask your surgeon about his or her record with the specific procedure you’re having, and about successes and complications.
  Be sure the nurses and other clinical staff who support the surgeon are also experienced with the procedure and have the appropriate medical education and training.

• Who is providing and monitoring the anesthesia? Be sure an anesthesiologist is leading your anesthesia care, especially if you are having general anesthesia or sedation. An anesthesiologist also can make sure you get the most effective pain management after your procedure.
• Is the surgery center licensed and well-equipped to handle your procedure? Although rare, emergencies can occur during surgery. Unlike hospitals, an office-based or same-day surgery site may not have an emergency facility nearby, so it’s important to ask if the surgery center has emergency medications, equipment, and procedures in place to safely care for you if there is an emergency. The outpatient surgery center should be licensed and accredited.

For more information on preparing for surgery, visit Preparing for Surgery.

Anesthesiologists are the most highly skilled medical experts in anesthesia care, pain management, and critical care medicine. They have the education and training that, in some circumstances, can mean the difference between life and death.

Outpatient Surgery | Johns Hopkins Medicine

What is outpatient surgery?

With improved technology and advances in anesthesia and pain control, many less invasive surgical procedures are now being performed on an outpatient, or ambulatory, basis. Common procedures that are now routinely performed on an outpatient basis include tonsillectomies, hernia repairs, gallbladder removals, some cosmetic surgeries, and cataract surgeries. Given the millions of procedures performed every year, complications from outpatient procedures are relatively uncommon.

Not all patients are candidates for outpatient surgery. If you have certain procedures, you will need to be hospitalized. A patient’s medical history and the advice of the surgeon and anesthesiologist are important in determining if the procedure is best performed on an outpatient or inpatient basis.

What kind of operation may be appropriate for outpatient surgery?

The most appropriate procedures for outpatient surgery. In you have certain procedures, you will need to be hospitalized are those associated with postoperative care that is easily managed at home. Also, those procedures with very low rates of postoperative complications. These need the care of a healthcare provider or nurse.

Where is outpatient surgery performed?

Outpatient surgery is performed in a variety of settings. Ambulatorysurgical centers are located either within a hospital setting or as a freestanding satellite facility. This may be either independent or part of the local hospital. Some procedures may actually be performed right in the healthcare provider’s office.

What are the benefits of outpatient surgery?

There are many advantages of outpatient surgery over traditional, inpatient surgery. These include the following:

• Convenience.The convenience of recovering in your home generally makes recovery time easier than an in-hospital stay.

• Lower cost.Since there are no hospital room charges, and related hospital charges, costs are much lower for outpatient surgery. Some insurance companies will cover certain surgical procedures only on an outpatient basis. The exception to this is if your healthcare provider certifies that you need a more intensive level of postoperative care due to an underlying medical condition.

• Reduced stress.In the majority of cases, outpatient surgery is less stressful than inpatient surgery. This is especially true for children who are afraid of being away from home. Most people prefer to recover in their homes rather than in the hospital.

• Scheduling is more predictable.In a hospital setting, emergency surgeries and procedures that take longer than expected can delay scheduled surgeries. An outpatient setting can generally stay within a set schedule since the procedures are less complex and more routine.

Is outpatient surgery safe for elderly patients?

Age, alone, is not a reason to disqualify an elderly patient from having outpatient surgery. However, age does affect the reaction of elderly patients to certain anesthetic medicines. Short-acting medicines often take a longer time to be metabolized by elderly people. Elderly people may also have more underlying medical conditions that could make an outpatient surgery riskier. It is important for an elderly patient to have a thorough medical evaluation before any surgery to determine the best surgical setting for that individual for the best result.

How soon after surgery do patients go home?

The scheduled time of discharge depends on the type of surgery, the anesthesia used, insurance coverage, and the policy of the surgery center. In general, most patients go home between 1 and 4 hours after outpatient surgery. The surgeon or anesthesiologist can give you more specific information based on your case. Occasionally, it is necessary for a patient to remain overnight. All ambulatory surgical facilities have arrangements with a hospital if this becomes necessary.

What are the responsibilities of the ambulatory patient when back home?

Patients who undergo an outpatient procedure should have someone to drive them home and stay with them following the procedure. Most patients are restricted from driving for at least 24 hours after surgery. Patients often experience drowsiness and minor after-effects. These include muscle aches, sore throat, and occasional dizziness and headaches. Occasionally, nausea may also be present. There may also be fatigue and discomfort for a day or two following the surgery. This discomfort varies depending on the type of surgical procedure performed.

Once at home, the patient must be able to tolerate any pain from the procedure with the prescribed pain medicine. The patient must be able to follow written and verbal instructions for proper pain management. A nurse or the healthcare provider will generally follow up these instructions to make sure the patient is recovering normally. The patient will also receive telephone numbers to call if there are concerns or emergency help is needed.

UFA RESEARCH INSTITUTE OF EYE DISEASES FGBOU VO BSMU MINISTRY OF HEALTH OF RUSSIA Department of outpatient surgery

Address: 450008, Ufa, st. Avrory, 14, hospital, building 1, 1st floor.

Tel.: +7(347) 255-30-21

The Department of Outpatient Surgery provides self-supporting appointments. The department provides qualified ophthalmological care:

• on a voluntary basis,
• when providing ophthalmic care to citizens of another state, stateless persons,
• on other terms than those stipulated by the program of state guarantees of free provision of medical care to citizens.

To provide qualified ophthalmological care, the necessary instrumental and hardware studies are carried out using modern methods of examining patients, consultations of doctors and candidates of medical sciences are carried out.

Department of Surgery:

The department of outpatient surgery provides a wide range of ophthalmosurgical care, starting with surgical interventions on the adnexa of the eye, ending with vitreoretinal operations.

The availability of modern diagnostic equipment, operating equipment and trained highly specialized specialists (doctors of science, candidates of science, doctors with the highest category) allows us to provide qualified specialized care at a high level for various diseases of the organ of vision.

Branch employees perform:

Cataract surgery: Cataract phacoemulsification or refractive lens replacement, femtolaser cataract phacoemulsification or refractive lens replacement with implantation of artificial lenses from leading foreign manufacturers.

Phacoemulsification is the removal of a cataract with an ultrasonic probe by crushing and suctioning it through a micro incision (2.2 mm). Through the same micro-incision, an artificial lens is inserted into the place of the one removed using a special syringe – injector.

Surgical interventions on the accessory apparatus of the eye:

• Removal of pterygium of all degrees of complexity
• Removal of neoplasm of eyelid skin with plasty
• Removal of neoplasm of the conjunctiva of the eyeball
• Curl
• Removal of eversion
• Elimination of blepharochalasis
• Chalazion removal
• Lacrimal lavage
• Activation of the lacrimal opening
• Eyelash electro-laser epilation
• Transcanalicular laser dacryocystorhinostomy
• Strabismus treatment

Vitreoretinal surgeries:

• Microinvasive vitrectomy, sutureless (25 G)
• Sutureless microinvasive vitrectomy (25 G) with tamponade of the vitreal cavity with a gas-air mixture
• Sutureless microinvasive vitrectomy (25 G) with perfluororganic tamponade of the vitreal cavity
• Revision of the vitreal cavity with tamponade with a gas-air mixture
• Vitreal cavity revision with silicone oil tamponade
• Revision of the vitreal cavity with perfluororganic tamponade
• Vitrectomy with membraneectomy
• Intravitreal drug administration

Conservative treatment of patients.

Price list of paid medical services

Employee work schedule

Payment procedure for medical services

Addresses and phone numbers of departmental organizations

Outpatient Surgery Center – Inpatient

Outpatient Surgery Center

The Outpatient Surgery Center performs surgical interventions that do not require a daily stay in the hospital. A surgical laser is used in a number of operations. Operations are performed under local anesthesia.
Treatment at the Center for Outpatient Surgery is carried out under the compulsory medical insurance policy, VHI, or on a paid basis.

Department Gallery

Doctors

Reception is carried out by highly qualified specialists

Anna Zheromovna Meltsova

Head of the Ambulatory Surgery Center, surgeon, vascular surgeon, phlebologist, candidate of medical sciences

Pilkevich Olga Yaroslavovna

Surgeon of the highest category, candidate of medical sciences

Chesnokova Alexandra Anatolyevna

Surgeon

Yulia Viktorovna Popova

Surgeon

Removal of benign neoplasms of soft tissues

Ingrown toenail surgery

Diseases

The department treats a wide range of diseases

• Ingrown toenail
• Hemangioma
• Benign neoplasms of soft tissues (lipoma, fibroma, hemangioma, keratoma, nevus, papilloma)
• Keloid scar
• Keratoma
• Lipoma
• Nevus
• Papilloma
• Epidermal cysts (atheromas)

Patient testimonials

I want to express my deep gratitude to the head of the Center for Outpatient Surgery, doctor Meltsova Anna Zheromovna. After 9months of unsuccessful treatment in a commercial clinic, I turned to Anna Zheromovna. I was very nervous and very afraid of further complications. Anna Zheromovna reassured me, gave me complete information about the condition of the veins, about the upcoming operation and recovery. Operation was successfully completed! I had no pain thanks to the well-executed local anesthesia! I was completely scared for nothing! And in the future, no long-term rehabilitation! Within a week I felt an improvement. And after 4 weeks, there was no trace of the previous pain.
Anna Zheromovna is an ideal doctor of a high professional level. Sensitive, attentive, caring doctor.
I would like to note the friendly, calm atmosphere in the Center for Ambulatory Surgery, the well-coordinated work of the Center’s staff under the leadership of Anna Zheromovna. I wish Anna Zheromovna and her team good health, joy, prosperity and happiness! Thank you for your work!

Lazarenko Tatyana Borisovna 06/01/2023

At the outpatient surgery department, atheromas were removed for me. The doctor Pilkevich Olga Yaroslavovna worked. Many thanks for the warm, sensitive and caring attitude. When you are nervous and worried, the excellent attitude of the doctor is very important. Olga Yaroslavovna is always caring and calm. And I never doubt her qualifications and professionalism. More such wonderful doctors.

Golikova Maryana 17.02.2023

Recently, out of necessity, I ended up in the outpatient surgery department. I am very glad that I was “in the hands” of an experienced surgeon Pilkevich Olga Yaroslavna. A professional in his field. Everything is very efficient and high quality. Received recommendations for the future. Thank you, Olga Yaroslavna. I recommend to everyone!

Podshivalova Alla Borisovna 12/24/2022

We would like to express our deep gratitude to Anna Zheromovna and her team! The treatment was at a professional level, moreover, everything took place in a very calm, warm atmosphere with sensitivity and care. Under the skilful guidance of Anna Zheromovna, everything works like a single well-coordinated organism. It can be seen that the staff loves their job and really wants to help people, this is a rarity in our time. We wish Anna Zheromovna and her team, as well as all the medical staff of the Mariinsky Hospital, good health, physical, emotional and spiritual strength, patience, more joyful events, family well-being and love! Thank you for your selfless work! Sincerely, Vladimir and Irina K.

Vladimir K. 11/29/2022

I want to express my sincere gratitude and deep respect to all the staff of the Center for Ambulatory Surgery and personally to the vascular surgeon, phlebologist Anna Zheromovna Meltsova for their attentive attitude, kindness and high professionalism!
I came for a consultation to Anna Zheromovna, as it seemed to me, with a difficult problem to solve – varicose disease of the left lower limb, complicated by thrombophlebitis. Thrombi formed at the level of the thigh and lower leg, were multiple and large in size. The conclusion was unequivocal: an operation is needed, such blood clots practically do not dissolve with conservative treatment. Anna Zheromovna convinced me that it was necessary not only to remove blood clots, but also to remove the cause – a varicose vein. A week after the appeal, an operation was performed, which was successful. Anna Zheromovna Meltsova uses all modern methods of treating varicose veins. I had a combined phlebectomy using endovenous laser photocoagulation of the great saphenous vein. The operation was performed under local anesthesia, an hour after the operation I was on my feet and was allowed to go home. So my difficult problem was solved quickly, efficiently, beautifully, professionally!
Anna Zheromovna Meltsova is a surgeon from God, a highly professional specialist, an attentive and sensitive person! I express my immense gratitude and deep respect to her!
I would like to especially note and thank everyone who works here for the wonderful friendly atmosphere that has been created at the Ambulatory Surgery Center! Thanks a lot!

Bulgar Natalia Mikhailovna 11/16/2022

I ask you to express gratitude to the surgeon-phlebologist Anna Zheromovna Meltsova.