a brief note on ambulatory surgeries

1. UNIT I AMBULATORY
SURGERY

2. CONTENTS
• INTRODUCTION
• DEFINITION
• IMPORTANCE
• FUNCTIONS
• AMBULATORY SURGICAL CARE FACILITY
• THE AMBULATORY SURGICAL PATIENT
• PATIENT NURSE RELATIONSHIP
• INTRA-OPERATIVE CARE
• RECOVERY
• DISCHARGE AND FOLLOW UP
• SOME IMPORTANT AMBULATORY SURGERIES
• ADVANTAGES OF AMBULATORY SURGERY

3. INTRODUCTION
• There are some surgeries that does not require hospitalization.
• Prolonged hospitalization after surgery increases the risk of infection.
• Some surgeries are performed in OPD (out-patient department) basis.
• They are called as day care surgeries or ambulatory surgeries.

4. DEFINITION
• Ambulatory surgery, also known as outpatient surgery or day care surgery, refers
to surgical procedures that are performed on patients who do not require an
overnight hospital stay.
• These surgeries are typically of a relatively minor nature and can be completed
within a few hours.
• After the surgery, patients are observed for a short period in a recovery area and
then discharged to recover at home.
• Ambulatory surgery centers or outpatient facilities are equipped to provide a safe
and efficient environment for performing these procedures, offering convenience
to patients while minimizing the need for hospitalization.

5. IMPORTANCE
• A hospital is able to provide an integrated set up using the dedicated ambulatory care
facility or day care services.
• Day care surgical services provide same standard of care as for in-patients.
• Only difference is that admission, diagnosis, surgical treatment and discharge is on same
day.
1.Minimizes hospital stays
2.Cost-effective
3.Faster recovery
4.Convenience for patients
5.Reduced risk of complications
6.Efficient use of resources
7. Advances in medical technology
8.Patient satisfaction

6. FUNCTIONS OF AMBULATORY SURGERIES
• To reduce waiting time
• To reduce IP admission
• To make hospital services convenient and comfortable for the patient
• To reduce disruption of personal lives
• To prevent nosocomial infections
• To encourage early recovery & mobilization in a home environment with their
family
• To reduce cost of surgery

7. AMBULATORY SURGICAL CARE FACILITY
• Ambulatory surgical facility is organized in such a manner that patients are
managed with treatment and discharge on the same day without overnight
hospitalization.
• The rise of ambulatory surgical facilities (ASFs) has brought about a significant
transformation in the healthcare industry.
• These specialized healthcare centers offer a range of surgical procedures that can
be performed on an outpatient basis, providing numerous advantages over
traditional hospital-based surgeries.
• It is important to know about the concept of ambulatory surgical facilities,
discussing their benefits, role in enhancing patient care, impact on healthcare
costs, advancements in technology, and future prospects.

8. Enhanced patient care and convenience
• Ambulatory surgical facilities prioritize patient-centric care by offering a more
personalized and convenient experience. Patients benefit from shorter
waiting times, streamlined admission procedures, and increased flexibility in
scheduling surgeries. Moreover, the lower patient-to-staff ratio in ASFs
ensures that patients receive individualized attention throughout their stay.
The comforting and less intimidating environment of ASFs fosters a positive
patient experience, reducing anxiety and enhancing overall satisfaction.

9. Cost efficiency and reduced healthcare expenditure
• One of the key advantages of ambulatory surgical facilities is their cost-
effectiveness. Compared to inpatient hospital stays, outpatient surgeries in
ASFs incur significantly lower costs due to reduced overhead expenses,
shorter recovery periods, and decreased risk of hospital-acquired infections.
The efficient utilization of resources in ASFs translates into reduced healthcare
expenditure for patients, insurance providers, and government healthcare
systems.This affordability factor plays a pivotal role in widening access to
surgical interventions for a larger section of the population.

10. Technological advancements in asfs
• Ambulatory surgical facilities have been at the forefront of integrating cutting-
edge technology into their operations. Minimally invasive surgical techniques, such
as laparoscopy and arthroscopy, are commonly performed in ASFs, offering
benefits such as smaller incisions, faster recovery times, and reduced post-
operative pain. Furthermore, advancements in anesthesia and pain management
techniques have improved patient comfort during procedures. State-of-the-art
diagnostic equipment, telemedicine capabilities, and electronic health records
contribute to efficient communication and seamless coordination between
healthcare providers, resulting in improved patient outcomes.

11. Specialized procedures and collaborative care
• Ambulatory surgical facilities are known for their ability to provide
specialized procedures within specific medical disciplines. By focusing on
specific surgeries, ASFs can optimize resources, expertise, and
infrastructure, leading to improved outcomes and reduced complications.
Additionally, ASFs promote collaborative care by fostering partnerships
between surgeons, anesthesiologists, nurses, and other healthcare
professionals.This multidisciplinary approach ensures comprehensive pre-
operative assessments, optimized surgical plans, and coordinated post-
operative care, resulting in enhanced patient safety and recovery.

12. Future prospects and challenges
• The future of ambulatory surgical facilities holds great promise. Advancements
in technology, including robotic-assisted surgeries and artificial intelligence-
driven analytics, will further enhance the precision, safety, and efficiency of
procedures performed in ASFs.The expansion of outpatient services beyond
traditional surgical interventions, such as infusion therapies and chronic disease
management, may lead to the development of comprehensive ambulatory care
centers. However, challenges such as regulatory compliance, resource allocation,
and maintaining patient safety standards must be addressed to ensure the
sustainable growth and success of ASFs.

13. • Ambulatory surgical facilities have revolutionized the healthcare landscape by
providing patient-centered care, cost-effective solutions, and technological
advancements in surgical procedures.These facilities offer enhanced
convenience, shorter recovery times, and reduced healthcare costs, thus
benefitting patients, insurance providers, and healthcare systems. With
ongoing advancements and a focus on collaborative care, ASFs are poised to
continue shaping the future of surgical interventions, improving patient
outcomes, and widening access to high-quality healthcare services.

14. THE AMBULATORY SURGICAL PATIENT
• The ambulatory surgical patient represents a significant shift in healthcare
delivery, as advancements in medical technology and changes in patient
preferences have led to a rise in outpatient surgeries.This essay explores the
concept of the ambulatory surgical patient, highlighting the benefits,
challenges, and impact on healthcare systems. By examining the patient
experience, safety measures, recovery process, and future prospects, we gain
insight into the transformative potential of ambulatory surgery in empowering
patients and optimizing healthcare resources.

15. Patient-centric care and convenience
• The ambulatory surgical patient enjoys a unique experience centered
around convenience and personalized care. Outpatient surgeries eliminate
the need for hospital admissions, allowing patients to return home on the
same day.This convenience saves patients from the stress and disruption
associated with prolonged hospital stays. Ambulatory surgical centers offer
flexible scheduling, shorter wait times, and streamlined admission
procedures, ensuring a patient-centric approach that caters to individual
needs and preferences.

16. Safety measures and patient outcomes
• Patient safety remains a top priority in ambulatory surgical facilities. Rigorous
screening processes, pre-operative evaluations, and comprehensive patient
education contribute to ensuring optimal surgical outcomes.ASCs strictly
adhere to safety protocols, such as infection control measures, proper
sterilization techniques, and maintaining high-quality standards. Additionally,
advancements in anesthesia administration, monitoring technology, and
post-operative care significantly minimize the risk of complications, making
outpatient surgeries a safe and reliable option for patients.

17. Recovery and rehabilitation
• Ambulatory surgical patients experience a faster recovery process due to
several factors.With minimally invasive techniques and advanced surgical
equipment, procedures can be performed with smaller incisions, resulting in
reduced pain, scarring, and post-operative discomfort. Additionally, patients
can recover in the comfort of their own homes, surrounded by familiar
surroundings and the support of their loved ones. Comprehensive post-
operative instructions, including pain management strategies and follow-up
care, aid in a smooth recovery and promote a quicker return to normal
activities.

18. Impact on healthcare systems
• The rise of ambulatory surgical patients has had a significant impact on
healthcare systems worldwide. Outpatient surgeries in specialized
ambulatory surgical centers relieve the burden on hospital resources, such as
beds, operating rooms, and healthcare personnel.This optimization of
resources translates into reduced healthcare costs, increased efficiency, and
improved access to surgical interventions. As a result, hospital capacities can
be better utilized for critical cases, while ambulatory surgical facilities provide
cost-effective and timely care to a broader patient population.

19. Future prospects and challenges
• The future of ambulatory surgical patients holds immense potential for
continued growth and innovation. Advancements in technology, such as robotic-
assisted surgery and telemedicine, have the potential to further improve surgical
precision, patient outcomes, and remote patient monitoring.The expansion of
ambulatory services beyond traditional surgeries to encompass complex
procedures and chronic disease management can enhance the scope and impact
of outpatient care. However, challenges such as regulatory compliance,
reimbursement policies, and maintaining patient safety standards must be
addressed to ensure the sustainable development and success of ambulatory
surgery.

20. • The ambulatory surgical patient represents a transformative shift in
healthcare, empowering patients with convenient, personalized, and safe
surgical experiences.Through patient-centric care, rigorous safety measures,
and optimized recovery processes, ambulatory surgical facilities have
revolutionized healthcare delivery.The impact of ambulatory surgery on
healthcare systems, including cost-efficiency and improved access to surgical
interventions, cannot be overstated. As we look towards the future, ongoing
advancements in technology and a focus on patient outcomes will continue to
shape and enhance the ambulatory surgical experience, revolutionizing the
way we approach surgical care.

21. PATIENT NURSE RELATIONSHIP
• The patient-nurse relationship forms the cornerstone of healthcare delivery,
and this bond becomes particularly crucial in the context of ambulatory
surgeries. Ambulatory surgical centers (ASCs) are specialized healthcare
facilities where patients undergo surgical procedures on an outpatient basis.
This essay explores the significance of the patient-nurse relationship in
ambulatory surgeries, emphasizing its role in ensuring patient safety,
promoting holistic care, enhancing communication, and facilitating a smooth
recovery process.
• Definition: Patient-nurse relationship is a series of interactions between the
nurse & the patient in which the nurse assists the patient to attain positive
behavioral change and good health.

22. Ensuring patient safety and trust
• In the ambulatory surgical setting, establishing a strong patient-nurse
relationship is vital for ensuring patient safety.
• Nurses act as patient advocates, monitoring vital signs, verifying pre-operative
assessments, and ensuring proper adherence to safety protocols.
• By establishing trust, nurses alleviate patient anxiety, provide accurate
information about the surgical process, and address any concerns or questions
the patient may have.
• This trust forms the foundation of effective communication, enabling patients
to express their needs and allowing nurses to provide the necessary support and
reassurance.

23. Holistic care and patient education
• Ambulatory surgical nurses go beyond the technical aspects of surgery by providing
holistic care to patients.
• They consider the patient's physical, emotional, and psychological well-being
throughout the surgical journey.
• Nurses assess the patient's overall health status, manage pain and discomfort, and
offer emotional support during pre-operative and post-operative phases.
• Patient education plays a crucial role in the ambulatory setting, empowering patients
with knowledge about their condition, the surgical procedure, and the recovery
process.
• Nurses act as educators, ensuring patients are equipped with the necessary
information to actively participate in their care.

24. Effective communication and collaboration
• Clear and effective communication between nurses and patients is essential for
successful ambulatory surgeries. Nurses establish open lines of communication,
actively listening to patients, addressing their concerns, and providing timely
and accurate information.
• By involving patients in shared decision-making, nurses promote a collaborative
approach to care.This collaborative partnership extends to the interdisciplinary
healthcare team, where nurses act as liaisons, coordinating with surgeons,
anesthesiologists, and other healthcare professionals.
• This collaborative network ensures seamless care transitions, improved patient
outcomes, and a cohesive approach to patient management.

25. Continuity of care and follow-up
• In ambulatory surgeries, nurses play a pivotal role in ensuring continuity of
care from pre-operative to post-operative phases.
• They monitor patients closely during the immediate recovery period,
addressing any post-operative complications promptly. Nurses provide post-
operative instructions, including wound care, medication management, and
signs of potential complications.
• Furthermore, they arrange follow-up appointments and communicate with
patients regarding their progress, offering guidance and support throughout
the recovery process.This continuity of care strengthens the patient-nurse
relationship and contributes to positive patient experiences.

26. Future trends and challenges
• As ambulatory surgeries continue to evolve, nurses face various challenges in
the patient-nurse relationship. Rapid advancements in technology, changing
healthcare policies, and increasing patient acuity require nurses to adapt and
stay updated. Maintaining personalized care and a human connection amidst
the growing emphasis on efficiency and cost-effectiveness poses a challenge.
Additionally, addressing the unique needs of diverse patient populations and
ensuring cultural competency will be vital for building strong patient-nurse
relationships in ambulatory surgery settings.

27. • The patient-nurse relationship in ambulatory surgeries plays a crucial role
in ensuring patient safety, promoting holistic care, enhancing
communication, and facilitating a smooth recovery process. Nurses serve
as advocates, educators, and coordinators, establishing trust, empowering
patients, and facilitating collaborative care. By focusing on effective
communication, continuity of care, and addressing future challenges,
nurses can strengthen the patient-nurse relationship and contribute to
improved patient outcomes, satisfaction, and overall healthcare quality in
ambulatory surgical settings.

28. INTRA-OPERATIVE CARE
• Intraoperative care plays a critical role in the success of ambulatory
surgeries. As patients undergo surgical procedures on an outpatient basis, it
is essential to provide focused and comprehensive care during the
intraoperative phase.This essay explores the key aspects of intraoperative
care in ambulatory surgery, including patient preparation, monitoring,
infection control, anesthesia administration, and surgical team
coordination. By emphasizing safety, efficiency, and patient-centered care,
healthcare professionals can optimize the intraoperative experience and
contribute to successful outcomes.

29. Preoperative patient assessment and
preparation
• Thorough preoperative assessment is crucial to identify potential risks and
optimize patient outcomes. In ambulatory surgery, nurses and anesthesiologists
evaluate patients' medical history, allergies, and medication use, ensuring
appropriate preoperative fasting guidelines are followed. Patient education is
vital, as clear instructions regarding fasting, medication administration, and
arrival times help patients prepare for surgery effectively. Adequate
preoperative preparation minimizes complications and contributes to a smooth
intraoperative experience.

30. Monitoring and vital signs management
• Continuous monitoring of vital signs is a fundamental aspect of
intraoperative care in ambulatory surgery. Nurses and anesthesiologists
monitor heart rate, blood pressure, oxygen saturation, and end-tidal carbon
dioxide levels to ensure patient stability and detect any deviations from
baseline. Non-invasive monitoring devices, such as pulse oximeters and
blood pressure cuffs, are used to provide real-time data and enable prompt
interventions when necessary. Close attention to vital signs ensures patient
safety and helps prevent potential complications during the surgical
procedure.

31. Infection control and sterile technique
• Maintaining a sterile surgical environment is crucial in preventing surgical
site infections (SSIs) during ambulatory surgeries. Healthcare providers
adhere to strict infection control protocols, including proper hand hygiene,
surgical attire, and the use of sterile instruments and drapes. Surgeons and
nurses collaborate to create and maintain a sterile field, minimizing the risk
of contamination. Additionally, antibiotic prophylaxis may be administered
to further reduce the risk of SSIs, adhering to evidence-based guidelines and
individual patient needs.

32. Anesthesia administration and pain management
• In ambulatory surgery, anesthesia plays a pivotal role in ensuring patient
comfort, safety, and optimal surgical conditions. Anesthesiologists assess
patients' health status and determine the appropriate anesthesia technique,
such as general anesthesia, regional anesthesia, or monitored anesthesia
care. During the procedure, anesthesiologists closely monitor patients' vital
signs, oxygenation, and depth of anesthesia. Effective pain management
strategies, such as local anesthetics, patient-controlled analgesia, or oral
pain medications, are employed to minimize discomfort during and after
the surgery, facilitating a smooth recovery.

33. Surgical team coordination and
communication
• Intraoperative care in ambulatory surgery relies on effective coordination
and communication among the surgical team. Clear roles and
responsibilities are established, ensuring efficient workflow and optimal
patient outcomes. Nurses, surgeons, anesthesiologists, and other
healthcare professionals collaborate closely, sharing critical information,
anticipating needs, and addressing any concerns promptly. Effective
communication helps to prevent errors, promote patient safety, and ensure
smooth transitions between different phases of the surgery.

34. • Intraoperative care plays a vital role in the success of ambulatory surgeries,
encompassing various aspects such as patient preparation, monitoring,
infection control, anesthesia administration, and surgical team coordination.
By emphasizing patient safety, efficient workflow, and effective
communication, healthcare professionals can optimize the intraoperative
experience and contribute to positive patient outcomes.Attention to
preoperative assessment, vigilant monitoring, adherence to infection control
protocols, appropriate anesthesia administration, and collaborative teamwork
are key factors in providing high-quality intraoperative care in ambulatory
surgery settings.

35. RECOVERY
• The recovery phase is a critical component of ambulatory surgeries, as
patients transition from the operating room to home. Ambulatory surgical
centers (ASCs) prioritize efficient and safe recovery processes to ensure
optimal outcomes and patient satisfaction.This essay explores the
multifaceted aspects of patient recovery after ambulatory surgeries, including
post-anesthesia care, pain management, wound care, patient education, and
follow-up care. By focusing on holistic and personalized approaches,
healthcare professionals can facilitate a smooth recovery journey and promote
successful healing.

36. Post-Anesthesia Care and Monitoring
• Immediate post-operative care in the recovery area is essential for
monitoring patients' vital signs, assessing for any complications, and
ensuring a smooth transition from anesthesia. Qualified nurses closely
observe patients, monitor their oxygen saturation, blood pressure, heart
rate, and respiratory status, while providing individualized care and
emotional support. Continuous monitoring and vigilant assessment during
the early recovery phase contribute to early detection and prompt
management of any potential complications.

37. Effective Pain Management Strategies
• Proactive pain management is crucial to alleviate discomfort and promote a
comfortable recovery process for ambulatory patients. Nurses and
healthcare providers employ multimodal pain management strategies,
including oral pain medications, regional anesthesia techniques, non-
pharmacological interventions, and patient-controlled analgesia. By
tailoring pain management plans to individual patient needs and providing
ongoing assessment and adjustment, healthcare professionals aim to
minimize pain and improve overall patient comfort during the recovery
period.

38. Wound Care and Infection Prevention
• Proper wound care is essential for the healing process after ambulatory
surgeries. Nurses provide detailed instructions regarding wound care,
including dressing changes, hygiene practices, and signs of infection.
Patients are educated on proper wound care techniques and encouraged to
actively participate in their own recovery. Strict adherence to infection
prevention measures, such as hand hygiene, aseptic techniques, and
prescribed antibiotic regimens, reduces the risk of surgical site infections
and supports successful healing.

39. Patient Education and Recovery Guidelines
• Patient education plays a crucial role in empowering ambulatory patients
during the recovery phase. Nurses provide comprehensive information on
post-operative care, including activity restrictions, medication
management, dietary considerations, and signs of complications. Clear and
concise instructions enable patients to actively participate in their recovery,
adhere to prescribed regimens, and make informed decisions. Additionally,
patient education may include providing resources, such as written
materials or access to online platforms, to support ongoing recovery and
address any concerns or questions.

40. Follow-up Care and Monitoring
• After discharge from the ASC, follow-up care and monitoring are vital to
ensure the continuity of care for ambulatory patients. Nurses schedule and
coordinate post-operative appointments, facilitating timely evaluations
with surgeons or healthcare providers.This follow-up care allows for
ongoing assessment of the patient's progress, evaluation of surgical
outcomes, and adjustment of treatment plans if necessary. Communication
channels between healthcare professionals and patients are maintained to
address any post-operative issues, provide additional support, and ensure a
smooth transition to normal daily activities.

41. • The recovery of ambulatory patients after ambulatory surgeries involves
comprehensive care and support throughout the healing process. Post-
anesthesia monitoring, effective pain management, wound care, patient
education, and follow-up care are vital components that contribute to successful
recovery. By providing individualized care, clear instructions, and ongoing
support, healthcare professionals can optimize the recovery experience for
ambulatory patients, promoting successful healing, enhancing patient
satisfaction, and ultimately improving overall healthcare outcomes in
ambulatory surgery settings.

42. DISCHARGE AND FOLLOW UP
• Discharge and follow-up processes for ambulatory patients are crucial
components of ambulatory surgery. As patients transition from the surgical
center to home, appropriate planning, education, and communication are
essential to ensure a smooth recovery and long-term well-being.This essay
explores the discharge and follow-up procedures for ambulatory patients,
focusing on discharge criteria, post-operative instructions, coordination with
healthcare providers, and the significance of follow-up appointments in
promoting continuity of care.

43. Discharge Criteria and Evaluation
• Before discharging ambulatory patients, healthcare professionals assess
various factors to ensure patient readiness for home recovery.This
assessment includes criteria such as stable vital signs, adequate pain
control, recovery from anesthesia, minimal bleeding, and the ability to
tolerate oral intake. Nurses and physicians evaluate patients' physical
and mental status, reviewing the results of post-operative assessments
and ensuring that patients meet the predetermined discharge criteria for
safe recovery at home.

44. Post-Operative Instructions and Patient
Education
• Comprehensive post-operative instructions are provided to ambulatory
patients to guide their recovery process. Nurses play a pivotal role in
educating patients and their caregivers about wound care, medication
management, activity restrictions, signs of complications, and when to seek
medical assistance. Instructions may be provided both verbally and in
written format, ensuring that patients have clear and accessible information
to refer to during their recovery period. Patient education empowers
individuals to actively participate in their recovery and take necessary steps
to promote healing.

45. Coordination with Healthcare Providers
• Coordinated communication between ambulatory surgical centers (ASCs)
and primary care providers is crucial for the overall well-being of ambulatory
patients. ASCs share relevant medical information, surgical reports, and
post-operative instructions with primary care physicians, enabling
continuity of care.This collaboration ensures that primary care providers
have a comprehensive understanding of the patient's surgical experience
and can provide appropriate follow-up care and ongoing management of
any pre-existing conditions.

46. Importance of Follow-up Appointments
• Follow-up appointments are an integral part of the ambulatory patient's
recovery journey.These appointments allow healthcare providers to assess
the patient's progress, monitor wound healing, manage any ongoing
symptoms, adjust medication regimens if needed, and address any
concerns or questions. Follow-up visits provide an opportunity for patients
to discuss their recovery experience, receive guidance, and ensure that their
overall health is monitored and optimized.

47. Utilization ofTelemedicine and Remote
Monitoring
• In recent years, the use of telemedicine and remote monitoring has become
increasingly prevalent in the follow-up care of ambulatory patients.
Telemedicine allows for virtual consultations, where patients can communicate
with healthcare providers through video calls or secure messaging platforms.
Remote monitoring devices, such as wearable sensors or mobile applications,
enable healthcare professionals to track vital signs, assess wound healing, and
monitor patients' progress remotely.These technologies provide convenience,
reduce unnecessary travel, and enhance patient engagement in their own
recovery.

48. • The discharge and follow-up processes for ambulatory patients are critical for
ensuring continuity of care and promoting successful recovery. By establishing
discharge criteria, providing thorough post-operative instructions,
coordinating with primary care providers, and scheduling follow-up
appointments, healthcare professionals ensure that ambulatory patients
receive appropriate support and monitoring throughout their recovery journey.
Utilizing telemedicine and remote monitoring further enhances the
accessibility and effectiveness of follow-up care. By prioritizing these
processes, healthcare providers optimize patient outcomes, facilitate smooth
recoveries, and contribute to the overall success of ambulatory surgery.

49. SOME IMPORTANT AMBULATORY
SURGERIES
• Ambulatory surgeries, also known as outpatient or same-day surgeries, are
medical procedures that do not require an overnight stay in the hospital.They
are typically performed in ambulatory surgery centers or specialized clinics.
Here are a few examples of important ambulatory surgeries:
• Cataract surgery: It involves removing the clouded lens of the eye and
replacing it with an artificial lens.
• Arthroscopy:This procedure uses a small camera called an arthroscope to
diagnose and treat joint problems, such as repairing torn ligaments or
removing damaged cartilage.
• Laparoscopic cholecystectomy: It is the removal of the gallbladder using
minimally invasive techniques, often performed to treat gallstones or
gallbladder disease.

50. • Tonsillectomy: It is the surgical removal of the tonsils, typically done to treat
recurrent or chronic tonsillitis or sleep-related breathing disorders.
• Hernia repair:Various types of hernias, such as inguinal, umbilical, or hiatal
hernias, can be repaired through minimally invasive techniques in an ambulatory
setting.
• Endoscopic sinus surgery:This procedure is performed to treat chronic sinusitis
or nasal polyps by removing blockages and improving sinus drainage.
• Carpal tunnel release: It involves relieving pressure on the median nerve in the
wrist by cutting the transverse carpal ligament, often performed to treat carpal
tunnel syndrome.
• Breast biopsy: It is the removal of tissue samples from the breast to evaluate
abnormalities, typically done as a diagnostic procedure for breast cancer.
• Endoscopy:This procedure uses a flexible tube with a light and camera to
examine and treat conditions in the digestive tract, such as colonoscopy or
upper endoscopy.

51. • Excision of skin lesions: Removal of benign or cancerous skin growths,
moles, or lesions, often performed for diagnosis or cosmetic reasons.
• It's important to note that the suitability of a specific surgery for an
ambulatory setting depends on various factors, including the patient's
health condition and the complexity of the procedure.The list above
represents only a few examples, and there are many more types of
ambulatory surgeries performed by medical professionals.