Chirurgie ambulatoire: évolution des techniques et de la prise en charge chirurgicale. Vers une chirurgie d'excellence

Key points Day-case surgery has been made possible thanks to the development of surgical techniques such as video-assisted surgery. Mini-invasive surgery reduces the incisional size, decreases postoperative pain, and the duration of postoperative rehabilitation. Robot-assisted surgery is a new technical improvement which increases safety and accuracy of surgical procedures. Laser surgery decreases the risk of postoperative bleeding allowing day-case ablation of the prostate to be performed. Improvement in surgical management is related to: • a better risk management allowing to determine more appropriately the duration of hospital stay; • the control of postoperative nausea, vomiting, and pain; • the systematic use of postoperative rehabilitation protocols; • an optimization of patients’ management through the definition of clinical pathways. Day-case surgery is demanding, leading to surgeons, anaesthetists and all health care providers to better control patients’ management, in order to improve health care quality and safety.