Proctology in day surgery: surgical technique

In 2002 the law number 112 defined in Italy the Elementary Assistance Levels (Livelli Essenziali di Assistenza--L.E.A.), which are the medical procedures provided to all Italian citizens by the National Health System (Servizio Sanitario Nazionale), for free or after payment of a small fee. Each Italian Regional Government has to define for each pathology (as already categorized in Disease Related Groups--D.R.G.) a benchmark, which is the percentage of cases of each pathology which should be treated in Day Surgery. The benchmarks are thresholds that should not be exceeded to avoid fines or other penalties to the hospital. In order to meet the objectives required by Italian law, a Day Surgery Unit must be able to perform as many operations as possible with high quality, high effectiveness, high efficiency, low costs and a low percentage of complications ("zero defect" objective). To get as close as possible to this objective it is necessary to seek the best organisation and the best surgical technique.