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The first hospital-affiliated surgical unit designed specifically for ambulatory surgery in the state of California began functioning as part of Santa Barbara Cottage Hospital in 1973. As this text is readied for publication, the unit is in its tenth year of operation. More than 20,000 patients have undergone surgery there. The enthusiasm generated by ~\ir experience in Santa Barbara, along with the widespread, growing interest in ambulatory surgery, prompted us to undertake this volume. The first three chapters cover principles and administrative aspects, an esthesiology, and nursing in the ambulatory surgical center. Subsequent chap ters, the major portion of the text, provide detailed, meticulously illustrated descriptions of surgical procedures as they are done in the Santa Barbara Cottage Hospital Outpatient Surgical Center by the surgeons who work there. They reflect current practice and emphasize the techniques found most reliable by the surgeons who use them in the outpatient setting. This manual includes many of the operations most commonly performed in our facility and emphasizes the unique aspects of surgery and patient care in outpatient practice. The text is concise, practical, and based on our collective experience. The illustrations are, for the most part, drawn from the surgeon's perspective and faithfully render the actual appearance of the operative field during surgery. Supplementary cross-sectional and conceptual drawings are included to orient the reader.
List of contents
1 The Ambulatory Surgical Center.- History.- Types of Facilities.- Cost and Other Advantages.- Organization and Design.- Medical Staff.- Utilization of the Unit.- Complications.- Development of the Outpatient Surgical Center at Santa Barbara Cottage Hospital.- References.- 2 Patient Selection and Anesthesiology in the Ambulatory Surgical Center.- Patient Selection.- Instructions for the Patient.- Preoperative Evaluation.- The Anesthetic.- Selection of Pediatric Patient.- Postanesthesia Recovery.- Local Anesthesia.- Complications.- References.- 3 The Nurse's Role in the Ambulatory Surgical Center.- Staff Organization and Management.- Attitude of Personnel.- Selection Process for Personnel.- Staff Meetings.- Progression of a Patient Through the Outpatient Surgical Center.- Summary.- 4 Otorhinolaryngologic Surgery.- Ear: External.- Ear: Middle.- Nose.- Sinuses.- Tonsillectomy.- Adenoidectomy; Nasopharyngeal Biopsy.- Head and Neck Masses.- Salivary Gland.- Laryngoscopy.- Temporal Arteritis and Temporal Artery Biopsy.- References.- 5 General Surgery.- Abdominal Wall Hernia.- Breast.- Lymph Node Biopsy.- Scalene Lymph Nodes and Scalene Node Biopsy.- Muscle Biopsy.- References.- 6 Peripheral Vascular Surgery.- Vascular Surgery.- Hemodialysis Access Site Surgery.- References.- 7 Anorectal Surgery.- Anesthesia.- General Preparation of the Patient.- Polyps.- External Hemorrhoids.- Internal Hemorrhoids.- Anal Fissures.- Acute Anal Fistulas and Abscesses.- Condyloma Acuminata Anal Warts.- Foreign Bodies.- Pilonidal Disease.- References.- 8 Gynecologic Surgery.- Condyloma Acuminatum.- Bartholm's Cyst and Abscess.- Vulvar Biopsies.- Perineorrhaphy.- Colpoperineorrhaphy.- Hymenectomy.- Vaginal Biopsies.- Ambulatory Surgery of the Cervix.- Uterine Biopsy.- Dilatation and Curettage.- Minilaparotomy.- Laparoscopy.- Carbon Dioxide Laser Therapy in Gynecology.- References.- 9 Urologic Surgery.- Dorsal Slit for Phimosis and Paraphimosis.- Circumcision.- Meatotomy.- Vasectomy.- Needle Biopsy of the Prostate.- Testicular Biopsy.- References.- 10 Orthopedic Surgery.- Removal of Metal Fixation Devices.- Exostoses.- Olecranon Bursitis.- Ulnar Nerve Transplantation.- Operation.- Calcific Tendonitis of the Shoulder.- Knee Arthroscopy.- Surgery of the Foot.- Hallux Valgus (Bunion Deformity).- References.- 11 Hand Surgery.- Procedures Appropriate for Outpatient Care.- Procedures That May Be Undertaken in the Outpatient Surgical Suite.- Hand Surgery Equipment.- Tourniquet.- Anesthetic Techniques for Upper Extremity Surgery.- Principles of Outpatient Hand Surgery.- Fingertip Injuries and Amputations.- Technique for V-Y Advancement Flap.- Carpal Tunnel Exploration and Release.- Nerve Injuries.- Synovial Cyst ("Ganglion").- Chronic Constrictive Tenosynovitis.- Rupture of the Ulnar Collateral Ligament of the Metacarpophalangeal Joint of the Thumb (Gamekeeper's Thumb).- Treatment.- Extensor Tendon Lacerations.- Metacarpal and Phalangeal Shaft Fractures.- Mallet Finger and Mallet Fractures.- Dupuytren's Contracture Hand Neoplasms.- 12 Plastic Surgery.- Scar Revisions.- Excision of Cautery of Skin Lesions.- Elliptical Excisions on the Face.- Grafts.- Flaps.- Surgery of the Lips.- Hair Transplants.- Setback Otoplasty.- Rhinoplasty.- Blepharoplasty.- Rhytidectomy.- Augmentation Mammoplasty.- Mastopexy.- References.
