Johns Hopkins Health Alert
The Ins and Outs of Outpatient Surgery
Serious complications of outpatient surgery are rare, but it’s important to be prepared.Research shows that most outpatient procedures are safe and effective, but there are important differences among outpatient facilities that may make one type of facility a better -- and safer—option for your surgery.
Simple surgery, like hernia repairs or cataract surgery, are the most common outpatient procedures, but the widespread use of less invasive technologies has resulted in more complicated operations being performed on an outpatient basis. Outpatient hysterectomies, laparoscopic colon surgery and gastric bypass surgery, for example, are now done through tiny keyhole incisions in the abdomen. With smaller incisions; less operating time, bleeding and risk of infection; and shorter recovery periods, patients may leave the facility the same day of their surgery.
Outpatient procedures are performed at one of three locations: outpatient hospitals, ambulatory surgery centers and doctors’ offices. Outpatient hospitals are affiliated with, and usually directly attached to, a major hospital. Surgeons and medical staff are hospital employees and the outpatient facility has access to hospital administrative and medical resources, including the hospital’s wide range of specialists.
In contrast, ambulatory surgery centers are privately owned, freestanding surgical facilities. Many ambulatory surgery centers are dedicated to one surgical specialty, such as eye or orthopedic surgeries. Most are staffed with board-certified surgeons and nursing staff. Although your ambulatory surgery center’s surgeon may also be affiliated with a hospital, the ambulatory surgery centers and hospital may not be directly affiliated.
Your surgeon will help you determine if the ambulatory surgery center or the hospital is a better choice for your procedure. Since 85 percent of ambulatory surgery centers receive Medicare funds, most are frequently inspected by the federal government and subject to the same stringent federal requirements as any hospital; however, because the ambulatory surgery center is not affiliated with a hospital, the staff may not be “on call.” Moreover, if you develop complications and require emergency services or hospital admittance after your operation, hospital staff may have difficulty getting information from the ambulatory surgery centers as quickly as they could from an affiliated outpatient facility.
Your doctor will also help you determine where to schedule your surgery. Keep in mind that your surgeon’s schedule may impact the decision. You may want to meet with your surgeon beforehand to discuss any health concerns.
Posted in Healthy Living on February 14, 2007
Reviewed June 2011
Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer
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The American Heart Association has actually just weighed in on Monday, 2/1/907, about the issue of women and heart disease. One can't just blame any one single class of drugs.
For example, if we are what we eat, and obesity is at epidemic proportions in this country, then it stands to reason that the fat in our diet, and which we are retaining in our bodies, in our fat cells, can certainly cause harm. Fat secretes at least a half dozen substances which affect our metabolism and cardiovascular health in the most radical ways.
It is also a question of attitude--women often still think of heart problems as a 'man's disease' and indeed, are more terrified of breast cancer than the number one killer of women--heart attack.
We need to take a holistic approach and look at exercise, weight loss, diet, attitude, lifestyle, as well as medications and supplements we put in our bodies to discern the 'culprits' here. The main culprit is us!
Posted by: Jo | February 21, 2007 3:16 PM
I really appreciate your articles. I had three surgeries in 2003 for a detached retina and the doctor was unsuccessful in the process due to alot of bad luck. I had all this done on an outpatient procedure and was allowed if feeling well to go home the same night. I unfortunately had to spend the night due to extreme nausea from the anathesia. My point here is some more complicated cases of surgery should not be on an outpatient basis. I know alot of this is for insurance purposes, but in the long run of quality patient care it should not be like a drive through service if more complications arise from it. Thanks!
Posted by: Caroline | May 9, 2007 8:07 AM
I just had out patient surgery for an abdominal hernia. A 4 inch incision and insertion of mesh etc. I was treated well at the surgical center. I was given local anesthesia. I entered at 1:45PM and was discharged to my home at 4:00. I was nauseated, woozy, in pain, vomiting due to the pain medication. However, no amount of pleading on my part would allow me to stay over. I am on Medicare, but would have paid for a two day stay in the hospital across the street if I was allowed. "No can do" they said.
My comment is, this is akin to cruel treatment. There should be a obundsman at these facilities to get everyone prepared at home. Some suggestions would be proper bed, help with cooking, laundry, grocery shopping etc. Also, aids to daily living to help pick up things while laying flat on your back waiting to heal. A spouse can only do so much to reassure you that the wound looks swollen but ok. Do you have such a person at Johns Hopkins Outpatient Center?
Posted by: Eliza Dawn | May 9, 2009 5:50 PM
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Many sources of health alerts (Harvard Medical Letter, University of California Wellness Letter, American Heart Association, etc., etc.,) all refer to the fact that WOMEN are having more heart problems (heart attacks,Angina attacks, heart artery blockages and Angioplasty resulting in stents) than Men. In the alerts, none have stated the reason for it, and they are all researching for a definite reason why this happens. THEREFORE, I am asking why no researcher, nor research organization has seriously considered the following facts for the cause:
Bisphosphonate medications (Actonel, Fosamax, Boniva, etc.) are prescribed for women, much, much more than they are for men.
Bisphosponates build up cell formations and reinforce bones.
Bisphospnates can cause lasting BONE CELL CHANGES (even five or six years after stopping the medications)
THEREFORE, IF DEPOSITS AND CELL CHANGES ARE IN BONES------WHY NOT IN HEART ARTERIES AND HEART TISSUES ? ? WOMEN ARE TAKING BISPHOSPHONATES...... WOMEN ! ! !
------ Cecele Beringer Brecksville, Ohio (440) 526-4174
Posted by: jefferson | February 17, 2007 6:54 AM