Instituting an office-based surgery program in the gynecologist's office.

Office-based surgery (OBS) provides many advantages for the patient, physician, operating room team, and health care system. Newer technologies provide an array of procedures appropriate to the office setting, and with careful preparation, many can be performed without compromising patient safety or comfort. Several states have specific regulatory requirements for OBS, although half of them provide neither guidelines nor regulation. The Federation of State Medical Boards provides current regulatory information across the United States; the American College of Obstetrics and Gynecology has recently issued guidelines that provide recommendations for instituting an OBS practice, and the American Medical Association and the American Society of Anesthesiologists provide guidelines that promote patient safety and comfort in the office setting. Many issues must be considered before instituting an OBS program. Practices that perform invasive procedures requiring more than minimal sedation are encouraged to seek formal accreditation because it assures patients of quality of care. Residency programs and professional societies are encouraged to provide training in OBS surgery and to develop programs to mentor the next generation of physicians.