Ambulatory gynaecology: what can we do?

The aim of ambulatory gynaecology is to admit, treat and discharge the patient on the same day in an outpatient setting. Traditional inpatient operations are being rapidly replaced by office, outpatient or day surgery procedures. In this review, a brief assessment of current ambulatory gynaecological practice is attempted, followed by a discussion of audit and quality assessment methods. Epidemiological studies, clinical trials, socio-economic studies and meta-analyses offer research opportunities in the ambulatory setting. There is a need to review the training of junior gynaecologists and nurses in this field. At present, only a few gynaecology residency programmes offer experience in outpatient procedures and ambulatory care. Specific issues that need to be addressed include training, patient selection, consenting issues, decisions to cancel/transfer as inpatients, and the management of common gynaecological problems.