Ambulatory gynecologic surgery

A retrospective study evaluated the feasibility and safety of operative gynecologic procedures performed in an ambulatory surgical center. Between July 1993 and December 1995, 5766 women (mean age 36.9 yrs, range 13-95 yrs) who were referred to our center underwent surgery. The most common preoperative diagnoses were dysfunctional bleeding, missed abortion, postmenopausal bleeding, cervical dysplasia, mullerian duct malformation, infertility, endometriosis, adhesions, desire for sterilization, adnexal mass, lower abdominal pain, ectopic pregnancy, and fibroids. A total of 2351 laparoscopies, 2 laparotomies, and 3415 vaginal procedures were performed. The most common procedures were dilatation and curettage, 1455; hysteroscopy, 1051; adnexal surgery, 810; tubal ligation, 679; abdominal myomectomy, 186; operative hysteroscopy, 145; and cone biopsy, 118. The duration of surgery was 10 to 210 minutes. Most patients (99.51%) were discharged between 2 and 8 hours after surgery. Only 28 (0.49%) had to be admitted to the hospital; 18 women had preoperatively planned admissions and 10 were unexpectedly admitted postoperatively. The intraoperative and postoperative complication rate was 0.50% (29). We believe that ambulatory surgery is safe and efficient with proper patient selection and when the surgeon and the anesthetist have significant expertise.