What is outpatient surgery. How does it differ from inpatient procedures. What types of anesthesia are used in ambulatory surgeries. How to prepare for a same-day surgical procedure. What are the benefits and risks of office-based surgeries.

Understanding Outpatient Surgery: The Rise of Same-Day 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 has revolutionized the way patients experience surgical procedures, offering numerous benefits and changing the healthcare landscape.

Why has outpatient surgery gained such popularity? The reasons are multifaceted:

• Convenience for patients
• Reduced costs compared to inpatient procedures
• Lower risk of hospital-acquired infections
• Faster recovery times
• Advancements in surgical techniques and anesthesia

These factors have contributed to the widespread adoption of outpatient surgeries across various medical specialties.

Types of Outpatient Surgery Facilities: Where Are These Procedures Performed?

Outpatient surgeries can be performed in various settings, each offering unique advantages:

• Hospital-connected outpatient facilities
• Standalone ambulatory surgical centers
• Physician’s offices equipped for surgical procedures

The choice of facility often depends on the complexity of the procedure, the patient’s health status, and the available resources. Hospital-connected facilities may be preferred for more complex surgeries, while simpler procedures might be safely performed in a physician’s office.

Common Outpatient Procedures: From Minor to Major Surgeries

The range of surgeries that can be performed on an outpatient basis is extensive and continually expanding. Some common outpatient procedures include:

• Mole removal
• Hernia repair
• Knee replacement
• Cataract surgery
• Colonoscopy
• Breast biopsy
• Tonsillectomy

Advancements in minimally invasive techniques have allowed even more complex procedures to be performed in outpatient settings, reducing recovery times and improving patient outcomes.

Anesthesia Options in Outpatient Surgery: Tailoring Comfort to Procedure

One of the key elements in any surgical procedure is anesthesia. In outpatient settings, anesthesiologists work closely with surgeons to provide safe and effective pain management tailored to each patient and procedure. There are four main types of anesthesia used in outpatient surgeries:

1. General Anesthesia

General anesthesia induces a state of unconsciousness during the procedure. It is typically administered through a mask or intravenously and is often used for major outpatient surgeries such as knee or hip replacements. How does general anesthesia work? It affects the brain and entire body, ensuring that the patient remains unaware and pain-free throughout the surgery.

2. Regional Anesthesia

Regional anesthesia numbs a larger area of the body, such as from the waist down, through an injection or catheter, often placed in the spine. This type is commonly used for procedures on the abdomen, arms, or legs, as well as for childbirth. Patients remain awake but feel no pain in the numbed area. When might regional anesthesia be preferred over general anesthesia? It’s often chosen when the surgeon and anesthesiologist want the patient to be conscious but pain-free, allowing for quicker recovery and fewer side effects.

3. Monitored Anesthesia Care (MAC) or IV Sedation

MAC involves administering medication through an IV to relax the patient or induce sleepiness. The level of sedation can vary, ranging from light (where patients are awake but relaxed) to deep (where patients may have no memory of the procedure). This type of anesthesia is often used for minimally invasive procedures like colonoscopies. What are the advantages of MAC? It often allows for a quicker recovery time and can be adjusted easily during the procedure.

4. Local Anesthesia

Local anesthesia involves injecting medicine to numb a small, specific area. It’s typically used for minor procedures such as skin biopsies, repairing broken bones, or stitching cuts. Patients remain fully awake and alert during the procedure. Why is local anesthesia beneficial for certain outpatient procedures? It has minimal side effects, allows for immediate recovery, and is often the safest option for minor surgeries.

Preparing for Outpatient Surgery: Essential Steps for a Successful Procedure

Proper preparation is crucial for the success and safety of any outpatient surgery. While specific instructions may vary depending on the procedure and type of anesthesia, there are several general guidelines patients should follow:

Fasting Requirements

For procedures involving sedation or general anesthesia, patients are typically instructed not to eat or drink for several hours before surgery. This precaution helps prevent complications related to anesthesia. Why is fasting important before surgery? It reduces the risk of aspiration, where stomach contents could enter the lungs during anesthesia.

Transportation Arrangements

Patients undergoing procedures with anesthesia that causes drowsiness or impairs judgment should arrange for someone to drive them home after the surgery. Having a friend or family member present can also provide emotional support and help remember post-operative instructions.

Clothing Choices

Wearing loose, comfortable clothing is advisable, as patients may experience soreness or have bandages over incision sites after the procedure. How can clothing choices affect post-operative comfort? Loose-fitting garments are easier to put on and take off, reducing discomfort and avoiding pressure on surgical sites.

Planning for Recovery

Patients should plan for adequate recovery time at home, especially in the first 24 hours after surgery. This may include arranging for someone to stay with them, preparing meals in advance, and setting up a comfortable recovery area.

Benefits of Outpatient Surgery: Why Same-Day Procedures Are Gaining Popularity

The shift towards outpatient surgeries has been driven by numerous advantages for both patients and healthcare providers:

Cost-Effectiveness

Outpatient procedures typically cost less than inpatient surgeries due to reduced facility fees and shorter stays. How significant can the cost savings be? In some cases, outpatient surgeries can cost 30-60% less than the same procedures performed in an inpatient setting.

Reduced Risk of Infection

Shorter hospital stays and exposure to fewer patients can lower the risk of hospital-acquired infections. Why is this particularly important? Hospital-acquired infections can lead to serious complications and extended recovery times, making prevention crucial for patient safety.

Faster Recovery

Many patients prefer recovering in the comfort of their own homes, which can lead to faster healing and improved mental well-being. How does home recovery contribute to faster healing? Familiar surroundings, better sleep, and the ability to move around more freely can all contribute to a speedier recovery process.

Improved Scheduling Flexibility

Outpatient procedures often offer more flexible scheduling options, allowing patients to better plan around work and family commitments. This convenience factor has contributed significantly to the popularity of same-day surgeries.

Potential Risks and Considerations in Outpatient Surgery: Ensuring Patient Safety

While outpatient surgery offers numerous benefits, it’s important to consider potential risks and limitations:

Patient Selection

Not all patients are suitable candidates for outpatient surgery. Factors such as overall health, age, and the complexity of the procedure must be carefully evaluated. Who might not be a good candidate for outpatient surgery? Patients with certain chronic conditions, those at high risk for complications, or individuals undergoing very complex procedures may be better suited for inpatient care.

Post-Operative Complications

While rare, complications can occur after the patient has been discharged. It’s crucial for patients to understand warning signs and have clear instructions on when to seek medical attention. What are some red flags patients should watch for? Excessive bleeding, severe pain, high fever, or signs of infection should prompt immediate medical consultation.

Limited Monitoring Period

The shorter observation period in outpatient settings means that some complications might not be immediately apparent. How do healthcare providers mitigate this risk? Thorough pre-operative assessments, clear post-operative instructions, and follow-up care plans are essential components of safe outpatient surgical practices.

Home Care Responsibilities

Patients and their caregivers take on more responsibility for post-operative care in outpatient settings. This includes managing pain, caring for incisions, and monitoring for complications. What support do patients receive for home care? Detailed instructions, prescribed medications, and access to healthcare providers for questions or concerns are typically provided to ensure proper home care.

The Future of Outpatient Surgery: Trends and Innovations

The field of outpatient surgery continues to evolve, driven by technological advancements and changing healthcare needs:

Expanding Procedure Range

Advancements in surgical techniques and anesthesia are allowing more complex procedures to be performed on an outpatient basis. What types of surgeries might become outpatient procedures in the future? Joint replacements, certain cardiac procedures, and even some cancer surgeries are increasingly being performed in outpatient settings.

Telemedicine Integration

The integration of telemedicine in pre- and post-operative care is enhancing the outpatient surgery experience. How does telemedicine benefit outpatient surgical patients? It allows for remote consultations, follow-up appointments, and quick access to medical advice, improving convenience and potentially reducing complications.

Enhanced Recovery Protocols

Specialized protocols designed to speed recovery and reduce complications are being developed and refined for outpatient procedures. What do these protocols involve? They often include pre-operative optimization, minimally invasive techniques, multimodal pain management, and early mobilization strategies.

Patient-Centered Care Models

There’s an increasing focus on tailoring the outpatient surgery experience to individual patient needs and preferences. How is this changing outpatient care? From personalized anesthesia plans to customized recovery strategies, patient-centered approaches are improving outcomes and satisfaction in outpatient surgeries.

As outpatient surgery continues to grow and evolve, it’s reshaping the landscape of surgical care. The combination of advanced techniques, improved patient selection, and enhanced recovery protocols is making same-day procedures safer and more effective than ever before. While challenges remain, the trend towards outpatient surgery shows no signs of slowing, promising a future where more patients can benefit from the convenience, cost-effectiveness, and improved outcomes of same-day surgical care.

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.