ABSTRACT
In 1909, it was reported in the British Medical Journal that Dr. James Nicoll had performed more than 1700 operations (1). Although ambulatory surgery may not be a phenomenon of modern surgery, in recent years there has been growing interest in the performance of ambulatory procedures. With health care costs continuing to spiral upward, physicians, hospitals, patients, and third-party carriers are seeking ways to save health care dollars without jeopardizing the patients’ safety. The consequence of this search will be the performance of a large number of ambulatory procedures that heretofore have been (and still are, by many) thought to require hospital admission for safe performance. A number of factors have contributed to the acceptance of outpatient procedures. These factors include the development of improved local and general anesthetics, better surgical education encouraging patients to become ambulatory soon after operation, the public’s willingness to participate in nursing themselves and their families, the ability to satisfy the unique needs of the patient requiring elective operative care, the public’s increased interest in and knowledge of medical matters, and possibly, a healthier public. The changes have been achieved through technological advances, sustained by patient and provider preference, and driven largely by payment system changes (2).
