Exploring the world of ambulatory surgery

The 5th James H. Nicoll Memorial lecture was delivered at the 5th International Congress on Ambulatory Surgery, Boston, Massachusetts, 2003. A summary of historic events and modern concepts of care for the ambulatory surgical patient is summarized. Current guidelines of the American Society of Anesthesiologists were developed using an evidence-based model. Data, however, are lacking and conclusions based largely on consensus of experts. Morbidity and mortality are low frequency events. Large populations must be studied to identify and correct causative factors. Data from recent studies are noted and critiqued. Office-based surgery is a specific venue of concern.