Office-based Surgery

Surgeons are doing more than just checkups in their offices these days. Advances in medical technology have made it possible for physicians to perform more advanced and more complex surgical procedures in their offices. Whether it is vein surgery, skin cancer excisions, tummy-tuck, breast augmentation, facelift or a complex biopsy, these procedures can be completed in an office-based surgery suite. Since most patients want to avoid an overnight hospital stay after surgery, ambulatory surgical procedures have become very popular. That’s why almost one-half of all surgeries are now being done in an outpatient facility, either connected to a hospital or in a separate surgical center.

More recently, though, there has been a growing trend for surgery to be done right in a doctor’s office. Office-based surgery can offer the convenience of having a procedure done in a more comfortable setting with a quick return home. Charges associated with ambulatory surgery are less than fees charged at a large hospital. Charges associated with ambulatory surgery completed in an office setting are substantially lower.

Anesthetic Techniques in Office-based Surgery

The same anesthetic techniques used in hospitals and ambulatory surgical centers are used in office-based surgery. They include:

• Local anesthesia, which provides numbness to a small area of the body, such as a dermatologist might use to numb the skin around a mole before removing it.

• Monitored anesthesia (sedation/analgesia), during which a patient receives medications that relieve pain and make the patient drowsy. During surgery, the patient’s vital signs, including heart rate, blood pressure and oxygen level, will be watched closely in order to avoid sudden changes or complications.

• Regional anesthesia, which can include spinal blocks, epidural blocks or extremity blocks. Spinal and epidural blocks involve interrupting sensation from the legs or abdomen by injecting local anesthetic medication in or near the spinal canal. Other blocks can be performed for surgery on your extremities, or limbs, blocking sensations from the arm or leg.

• General anesthesia, which involves the total loss of consciousness, pain sensation and protective airway responses.

From the simple removal of a mole to breast augmentation/reduction, liposuction, hernia repairs or knee arthroscopies, a rapidly growing number of surgeries are being performed in doctors’ offices rather than in hospitals or ambulatory surgical centers. More complex procedures are likely to become common in the near future.

At last review in 2005, an estimated 10 million procedures were performed annually in doctors’ offices – twice the number of office-based surgeries performed in 1995. Today, about one out of 10 surgeries is performed in a doctor’s office.

In considering your options when surgery is advised, here are some items that you should consider before undergoing surgery in a doctor’s office. Ideally, anesthesia during larger surgical cases should be delivered or supervised by a person extensively trained in anesthesia techniques, like a Certified Nurse Anesthetist or Anesthesiologist.

Anesthesia needs are determined by your medical condition as well as by the type of operation you will have completed. A doctor’s office should have the necessary emergency drugs, equipment and procedures in place to care for you in the rare event of a life-threatening complication. Many states require licensing or accreditation by a recognized agency. These agencies regularly inspect such offices to ensure that minimum standards of patient care and safety are met. Ask your doctor if their surgical office suites have been accredited.

Advanced Surgical Concepts is a fully accredited AAAHC facility.