Ambulatory Surgery Services: Changing the Paradigm of Surgical Practice

Abstract

Once surgeons felt comfortable bringing patients into hospitals, “kitchen surgery” transitioned into hospital surgery. It was normal to wait weeks or months for an appointment, and patients typically spent several days in the hospital before even relatively minor surgical procedures such as groin hernias. Postsurgically, they would stay in the hospital for days or weeks. Now, those days are gone, and patients arrive on the same day as surgery, even for the most complex surgical procedures such as cardiac, vascular, and transplant. With the creation of surgery centers, advances of laparoscopic and arthroscopic surgery, and advances in anesthesia, this approach has become a reality. Insurance companies will no longer reimburse for lengthy hospital stays unless a patient is critically ill. The new norm can now almost be considered “drive-through” surgery. This chapter explores the current state of ambulatory surgery.