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 an outpatient procedure.

Understanding Outpatient Surgery: A Modern Approach to Medical Procedures

Outpatient surgery, also known as same-day, ambulatory, or office-based surgery, has become increasingly common 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 towards outpatient procedures offers numerous benefits for patients, including increased convenience, reduced costs, and potentially lower infection risks.

Outpatient surgeries can be performed in various settings, such as:

• Facilities connected to hospitals
• Separate surgical centers
• Physicians’ offices

These procedures typically range from simple mole removals to more complex operations like hernia repairs or knee replacements. The duration of outpatient surgeries can vary from a few minutes to several hours, depending on the complexity of the procedure.

Types of Anesthesia Used in Outpatient Surgery

Regardless of the surgical setting, patients undergoing outpatient procedures will receive some form of anesthesia or pain medication. The type of anesthesia used depends on various factors, including the nature of the procedure and the patient’s medical history. Here are the four main types of anesthesia used in outpatient surgery:

1. General Anesthesia

General anesthesia is administered through a mask or intravenously (IV), causing the patient to become unconscious during the procedure. This type of anesthesia is typically used for major operations such as knee or hip replacements.

2. Regional Anesthesia

Regional anesthesia is usually administered through an injection or a thin tube called a catheter, often in the spine. It numbs a larger part of the body than local anesthesia, such as from the waist down. This type of anesthesia is commonly used for procedures like childbirth or surgeries of the abdomen, arm, or leg.

3. Monitored Anesthesia Care (MAC) or IV Sedation

This type of anesthesia involves administering medication through an IV to relax the patient or induce sleepiness. There are several levels of sedation, and patients may react differently. Some remain awake and can communicate but feel no pain, while others fall into a deep sleep and have no memory of the procedure. MAC is often used for minimally invasive procedures like colonoscopies and may be combined with local anesthesia.

4. Local Anesthesia

Local anesthesia typically involves a one-time injection of medicine that numbs a small area. It’s used for minor procedures such as skin biopsies, repairing broken bones, or stitching deep cuts. Patients remain awake and alert but don’t feel pain in the treated area.

Preparing for Outpatient Surgery: Essential Steps for a Successful Procedure

Proper preparation is crucial for ensuring a safe and successful outpatient surgery experience. Here are some essential steps to follow:

1. Follow pre-operative instructions: Your physician will provide specific guidelines on how to prepare the night before and the day of your surgery. These instructions may vary depending on the type of anesthesia you’ll receive.
2. Fasting requirements: If you’re scheduled for sedation or general anesthesia, you may be instructed not to eat or drink anything for several hours before the procedure. This is usually not necessary for minor procedures requiring only local anesthesia.
3. Arrange for a companion: If you’re having anesthesia that puts you to sleep or sedates you, you won’t be able to drive yourself home. Having someone with you can also help you relax before the procedure and remember post-operative instructions.
4. Wear comfortable clothing: Choose loose, comfortable clothes that accommodate potential soreness or bandages covering incisions.
5. Plan for recovery time: Depending on the type of anesthesia used, you may need to be monitored for a few hours after the procedure. Once home, it’s advisable to have someone stay with you for at least the first 24 hours.
6. Prepare for side effects: Discuss potential pain or soreness with your anesthesiologist or surgeon, and learn about the best ways to manage these symptoms.

The Advantages of Outpatient Surgery: Why It’s Gaining Popularity

Outpatient surgery offers several benefits that contribute to its growing popularity among patients and healthcare providers:

• Convenience: Patients can recover in the comfort of their own homes, which can be less stressful and more comfortable than staying in a hospital.
• Cost-effectiveness: Outpatient procedures often cost less than inpatient surgeries, as they don’t require overnight hospital stays.
• Reduced infection risk: Shorter hospital stays may lower the risk of hospital-acquired infections.
• Faster recovery: Many patients experience quicker recovery times when they can rest and recuperate in familiar surroundings.
• Increased autonomy: Patients often feel more in control of their recovery process when they’re at home.

Common Outpatient Surgical Procedures: From Minor to Complex

Outpatient surgery encompasses a wide range of procedures, from simple to more complex operations. Some common outpatient surgical procedures include:

• Cataract surgery
• Arthroscopic joint procedures (e.g., knee, shoulder)
• Hernia repairs
• Gallbladder removal (laparoscopic cholecystectomy)
• Tonsillectomy
• Cosmetic surgeries (e.g., breast augmentation, liposuction)
• Dental procedures (e.g., wisdom tooth extraction)
• Endoscopic procedures (e.g., colonoscopy, upper endoscopy)

As medical technology advances, the list of procedures that can be performed on an outpatient basis continues to grow.

Post-Operative Care: Ensuring a Smooth Recovery After Outpatient Surgery

Proper post-operative care is crucial for a successful recovery after outpatient surgery. Here are some key aspects to consider:

Pain Management

Your surgeon or anesthesiologist will provide guidelines for managing pain after the procedure. This may include over-the-counter pain relievers, prescription medications, or non-pharmacological methods such as ice packs or elevation.

Wound Care

Follow your doctor’s instructions for caring for the surgical site. This may involve changing dressings, keeping the area clean and dry, or applying topical medications.

Activity Restrictions

Your healthcare provider will inform you about any limitations on physical activity during the recovery period. It’s essential to follow these guidelines to prevent complications and promote healing.

Follow-up Appointments

Schedule and attend all recommended follow-up appointments with your surgeon. These visits allow your doctor to monitor your progress and address any concerns.

Recognizing Complications

Be aware of potential signs of complications, such as excessive bleeding, severe pain, fever, or signs of infection. Contact your healthcare provider immediately if you experience any concerning symptoms.

The Future of Outpatient Surgery: Trends and Innovations

As medical technology continues to advance, the field of outpatient surgery is evolving rapidly. Some emerging trends and innovations in this area include:

Minimally Invasive Techniques

Advancements in minimally invasive surgical techniques are allowing more complex procedures to be performed on an outpatient basis, reducing recovery times and improving outcomes.

Telemedicine Integration

The integration of telemedicine in pre- and post-operative care is enhancing patient monitoring and follow-up, making outpatient surgeries even more convenient and accessible.

Enhanced Recovery After Surgery (ERAS) Protocols

ERAS protocols are being increasingly adopted in outpatient settings, focusing on optimizing patient outcomes through evidence-based practices in pre-, intra-, and post-operative care.

Artificial Intelligence and Machine Learning

AI and machine learning technologies are being developed to improve surgical planning, risk assessment, and post-operative monitoring in outpatient settings.

Patient-Centered Care Models

There is a growing emphasis on patient-centered care models in outpatient surgery, focusing on personalized treatment plans and improved patient education and engagement.

As outpatient surgery continues to evolve, patients can expect even more efficient, effective, and personalized surgical experiences in the future.

Making an Informed Decision: Is Outpatient Surgery Right for You?

While outpatient surgery offers numerous benefits, it may not be suitable for everyone. Here are some factors to consider when deciding if outpatient surgery is the right choice for you:

Medical History

Your overall health and medical history play a crucial role in determining your eligibility for outpatient surgery. Patients with certain chronic conditions or complex medical histories may require inpatient care.

Procedure Complexity

The nature and complexity of the surgical procedure will influence whether it can be safely performed in an outpatient setting. Some more complex surgeries may still require hospitalization.

Home Support

Consider whether you have adequate support at home for your recovery. If you live alone or don’t have someone who can assist you during the initial recovery period, inpatient surgery might be a safer option.

Personal Preferences

Some patients may feel more comfortable recovering in a hospital setting where medical staff is readily available. Consider your personal preferences and comfort level when making your decision.

Insurance Coverage

Check with your insurance provider to understand coverage for outpatient procedures versus inpatient surgeries. While outpatient surgeries are often more cost-effective, it’s essential to understand your financial responsibilities.

Ultimately, the decision to undergo outpatient surgery should be made in consultation with your healthcare provider, taking into account your individual circumstances and medical needs.

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

Surgical Department – GBUZ City Clinical Hospital No. 3, Krasnoda, Ministry of Health KK

Schedule of work of the surgical department specialists.

Day hospital is designed to provide patients with conservative care, and prompt care for patients who do not need long-term inpatient treatment.

The department has all conditions for conservative treatment and outpatient surgeries. The staff of the surgical department works according to the schedule daily from 8-00 to 15-48. Except weekends and holidays.

Medical assistance to the population is provided within the framework of the “Territorial Program of the State Guarantee of Free Medical Assistance to Citizens in the Krasnodar Territory” on referrals from polyclinics of the city and the region; insurance organizations, in accordance with voluntary medical insurance contracts and for paid services.

Tasks of the surgical department:

– Surgical outpatient treatment according to the profile – purulent soft tissue surgery in an emergency, as well as benign soft tissue neoplasms in a planned manner, after examination in a polyclinic for women.

– conservative treatment (infusion therapy) for angiosurgical patients who do not require surgical treatment;

Consultative and diagnostic stage.

Patients come to the consultative and diagnostic department by referral from polyclinics. You can make an appointment with a specialist by contacting the reception or by calling +7 (861) 2337901.

At an outpatient appointment, the diagnosis is specified, the required amount of examinations, consultations (if necessary) is determined. The question of choosing an operative or conservative type of treatment is being decided.

The provision of medical care may be limited only to the consultative and diagnostic stage, if no indications for treatment in the surgical department are identified.

If treatment is continued, the patient is referred to a day hospital for surgical or conservative treatment.

Day hospital (surgical treatment).

For planned surgical treatment, the patient is admitted to the day hospital of the surgical department on the day of the operation. At this stage, surgical intervention and postoperative treatment are performed.

Requirements for preoperative examination in elective patients are defined by the treatment standards.