Ambulatory gynaecological surgery: Risk and assessment

Assessment of patients undergoing elective surgical procedures on an outpatient basis carries risks that range from mortality through non-lethal injuries to costs incurred for inappropriate testing. Ambulatory surgery accounts for over 60% of elective surgical procedures for most areas of the USA, Canada and Australia and a growing proportion of procedures in Europe and Asia. However, data to determine the true risk of these procedures are difficult to find due to standardized criteria for risk assessment and management. Nonetheless, this type of medical procedure, with appropriate preparation, is regarded as safe and standard. Assessment of patients undergoing these procedures must take into consideration the nature of the medical and surgical conditions. Diagnostic testing is only performed if the results might change the management of the patient. At present, the American Society of Anesthesiology (ASA) classification system and the ASA guidelines for pre-anesthesia evaluation serve as the most current examples of risk assessments and algorithms that can be used for appropriate management of patients undergoing elective surgical procedures.