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.

This key resource provides insight and guidance to managing ambulatory surgery centers (ACSs) from a broad spectrum of expertise. Intended for a wide audience of healthcare professionals, this book covers topics such as regulatory issues, outpatient pediatric anesthesia, inventory management, personnel training, the culture of safety, and sedation standards. The format found in each chapter is designed intentionally to function as an educational manual. Many chapters are supplemented by high quality figures and tables to aid in visual learning. This text brings together authors from diverse professions including lawyers, administrators, surgeons, anesthesiologists and architects – all of whom have contributed their expertise to address the multitude of subjects that pertain to ASCs. Manual of Practice Management for Ambulatory Surgery Centers: An Evidence-Based Guide is a concise and evidence-based guide to successfully operating the modern health care facilities that have transformed the outpatient experience for millions of people.

Ambulatory Surgery Center Safety Guidebook: Managing Code Requirements for Fire and Life Safety helps guide ASC administrative and security staff meet the requirements and standards of both federal and state authorities, including the Life Safety Code, a critical designation for facilities participating in Medicare (CMS) funding reimbursement. Designed for easy reference, the book assumes no code knowledge on the part of ASC staff, and provides guidance for the policies, emergency plans, drills, inspection, testing and maintenance of fire protection and building systems necessary for meeting Life Safety Code requirements. Through sample checklists and log sheets, and a systematic process for completing required documentation, the reader is directed through the crucial steps to achieving code compliance. The guide provides ASC staff the knowledge necessary to be in compliance with the Life Safety Code without the need for an outside security or safety consultant. Through this compliance, facilities remain licensed and qualified for Medicare reimbursement, ultimately improving the financial success of the ASC. - Illuminates the requirements of the Life Safety Code for ASCs for medical and other administrative staff who possess no code knowledge in the ASC setting - Includes compliance requirements for the code, as well as requirements placed upon facilities desiring to participate in Medicare (CMS) funding reimbursement - Provides sample checklists and log sheets for each type of system - Outlines a systematic process for completing the documentation required of ASCs for inspection, testing and maintenance of facility systems crucial to achieving code compliance

Of all the developing fields of surgery, few have had the impact of vascular surgery in affecting so large a section of the population by offering the potential relief of disability and the prolongation of life. As would be anticipated, the interest of surgeons in this evolving specialty has largely been focused upon the selection of the most appropriate operations and the development of modifi cations or new procedures that overcome the limitations of previous ones. The literature contains numerous conflicting claims about the relative merits of various procedures, and those aPlJoaching this field for the first time may understandably be confused. Yet, if one were to approach any single vascular surgeon at any given time, he would upon request be given a firm and precise listing of preferred procedures. The procedures described in this two-volume publication are those that we currently favor. Their selection is the result of continuing analyses of our own experience during the past 30 years. All patients have been available for prolonged follow-up evaluation. Late failures often helped us to identify techniques that lessened the durability of an initially satisfactory operation, and they became a stimulus for the development of modifications or trials with alternative operations. Particular attention is directed to the manner in which knowledge of the natural history of disease influences the choice of operations.

Of all the developing fields of surgery, few have had the impact of vascular surgery in affecting so large a segment of the population with its potential for relief of disability or the prolongation of life. As would be anticipated, the interest of surgeons in this evolving specialty has been largely focused upon the selection of the most appropriate operations and the development of modifications or new procedures to overcome the limitations of previous ones. The literature contains numerous conflicting claims on the relative merits of various procedures. Those approaching this field for the first time may understandably be confused. Yet, if one were to approach any single vascular surgeon at any given time, he would, upon request, receive a firm and precise listing of preferred procedures. The procedures described in this two-volume publication are those which we currently favor. Their selection is the result of continuing anal ysis of our own experience of the last 25 years. All patients have been available for prolonged follow-up evaluation. Late failures often identified techniques that lessened the durability of initially satisfactory operations and stimulated the development of modifications or trials with alternate op erations. Particular attention is directed here to the manner in which knowledge of the natural history of disease influences the choice of opera tion.

The color photographs and illustrations appearing in select monographs over the past decade represent a significant advance in surgical commu nication. Previously, black and white renderings were standard because color printing had not been perfected and its cost was prohibitive. We be lieve the gradual change from black and white etchings and reproductions to detailed color illustrations represents a tremendous twentieth century achievement. In our own urologic practices it became evident that the use of black and white sketches for teaching operative urology, while helpful, left too much to the surgeon's imagination. Even the dimension of depth, produced by varying the intensity of shading, often was inadequate in demonstrat ing subtle surgical details in a fossa or bed. Since color photography recently has been used to demonstrate oper ative techniques, we climbed on the bandwagon and photographed in color many of the major operative procedures. However, the reflection of light caused by normal tissue fluid significantly reduces the clarity of photo graphs. Not infrequently, the crucial operative step is obscured by light reflected on a trickle of blood. Even when meticulous care is taken to ir rigate and clean the surgical field, the tissue sheen obscures portions of the field. Color paintings by a gifted artist are not only unique, but can be extraordinary; the vividness with which subtleties can thus be portrayed cannot be matched by photography, black and white or color.

This manual is intended as a comprehensive guide to the diagno sis and management of the burn patient. The author:s feel that this volume can serve as a practical reference for the wide range of physi cian and allied health personnel involved in the care of these critically ill patients. The Manual of Burns was planned and written by the authors when they were on staff together at the United States Army Institute of Surgical Research, Brooke Army Medical Center, Fort Sam Houston, Texas. The authors support the concept that appropriate therapy of the burn patient requires a multidisciplinary approach. The talents of physi cians from many medical specialties, supported by nurses, therapists, and other allied health science personnel, must be coordinated if such a patient is to receive optimum care. Although the main thrust of this manual is directed at current techniques of diagnosis and treatment and therefore of primary inter est to the physician, the authors also hope that the photographic and illustrative material will make this book useful to any member perform ing service in a burn treatment unit.

It is appropriate that a surgical teacher. Robert E. Hermann. M.D . . with a large experience in a specialized field should author the beautifully il lustrated Manual of StlrRery of the Gallbladder. Bile Ducts. and Exocrine Pancreas. This manual. which takes its place in the distinguished series sponsored by RiChard H. Egdahl, M.D . . is designed for the working sur geon. resident or practitioner. who wishes to refresh his memory or to bring himself abreast of current thinking and technics. The carefully planned format and the elegant color illustrations of Mr. Robert Reed per mit this with the expenditure of a minimum of time and effort. and sur geons who must operate on the organs and structures it covers will wish to have it available for reference. Stanley O. Hoerr. M.D. former Chairman. Division of Surgery Cleveland Clinic Chairman. Department of Surgery Fairview General Hospital Cleveland. Ohio Preface Operations on the gallbladder and bile ducts are among the surgical proce dures most commonly performed by general surgeons. In most hospitals, cholecystectomy is the most frequently performed operation within the ab domen; approximately 6()(), OOO are performed each year in the United States. In addition, an estimated 120,000 bile duct operations are performed yearly. Pancreatic surgery is less frequent, but because of the close relation between the biliary system and the pancreas, knowledge of pancreatic problems is equally essential to the surgeon.

The Manual of Upper Gastrointestinal Surgery was compiled as an aid to surgeons, residents, and students who want to acquire a broader knowl edge of the surgical techniques used in the upper gastrointestinal area. Of necessity, a considerable amount of the work of a general surgeon will be confined to this region. The techniques described herein are those preferred by the authors and most, but not all, of their colleagues at the Mayo Clinic. No attempt has been made to include all of the available possibilities and technical varia tions. Likewise, no attempt has been made to include many of the stapling techniques. Although they are good and quite useful, their inclusion would require a complete and separate volume. The omission of an accepted procedure is not meant as a criticism; our aim was to emphasize only the techniques that are most commonly used in day-to-day practice. Gains in knowledge about the anatomy and physiology of the esopha gus, stomach, and duodenum have been highly instrumental in the devel opment of surgical procedures in these areas, particularly the techniques for benign diseases (for example, ulcer, gastritis, and esophagitis).