Hand Surgery in an Ambulatory Surgery Center (ASC)
Hand surgery is a specialized branch of surgery that deals with conditions affecting the hand, wrist, and forearm. With advancements in surgical techniques and anesthesia, many of these procedures are now safely performed in ambulatory surgery centers (ASCs)—outpatient facilities designed to provide surgical care without requiring an overnight hospital stay. Their streamlined approach, combined with expert care, has made ASCs increasingly viable for hand surgery 1.
A wide range of hand surgery can be successfully carried out in an ASC. Procedures such as carpal tunnel release, trigger finger release, and tendon repair are among the most common. Surgeons may also, however, perform fracture fixation for broken bones in the hand or wrist, excision of ganglion cysts, and surgical correction of Dupuytren’s contracture. These procedures are often carried out with minimally invasive methods, which reduces recovery time and improves outcomes 2–5.
ASCs offer significant benefits for both patients and healthcare providers. Efficiency is one of the most important considerations. Patients typically arrive at the ASC, undergo surgery, and return home on the same day, thereby avoiding long hospital stays or complex inpatient routines. This efficiency extends to the surgical team as well, as ASCs are designed to streamline procedures and minimize delays. Cost is another major factor—procedures in ASCs are generally less expensive than those in hospitals, as ASCs operate with lower overhead and avoid many of the ancillary charges associated with inpatient care. In addition, the risk of infection is lower in ASCs due to the controlled, specialized environment and the exclusion of critically ill patients 3,6,7.
For hand surgery performed at an ASC, local or regional anesthesia is most often used. A nerve block can be administered to numb the entire hand or arm, allowing the patient to remain awake but pain-free during the operation. This type of anesthesia reduces the risks associated with general anesthesia and contributes to faster postoperative recovery times. Patients often experience several hours of pain relief following the procedure, thanks to the extended effect of the nerve block. The transition from surgery to home is thus smoother, and early recovery is typically more comfortable 8–10.
Once the surgery is finished, patients are monitored in a recovery area to ensure stability before being discharged. They are provided with detailed instructions for home care, including wound care, activity restrictions, and medication management. Follow-up appointments are scheduled to monitor healing and address any concerns. In cases where mobility or strength is affected, physical therapy may begin shortly after surgery. Because the hands are used nearly daily, rehabilitation is often an essential part of the healing process to restore function and prevent stiffness 11–13.
Hand surgery in an ASC combines surgical expertise with the benefits of convenience, safety, and cost-effectiveness. As healthcare continues to prioritize value and patient-centered care, the role of ASCs in delivering high-quality hand surgery is likely to expand.
References
1. What is an ASC? https://www.ascassociation.org/surgery-centers.
2. Knopp, B. W., Kushner, J., Eng, E., Goguen, J. & Esmaeili, E. Patient Experiences With Hand Surgery in the Office Versus Ambulatory Surgery Center. Cureus 15, e43763. DOI: 10.7759/cureus.43763
3. Thompson, N. B. & Calandruccio, J. H. Hand Surgery in the Ambulatory Surgery Center. Orthopedic Clinics of North America 49, 69–72 (2018). DOI: 10.1016/j.ocl.2017.08.009
4. Barkho, K., Tuttle, R., Kopp, L., Zylinski, M. & Day, C. Evaluating Value of Trigger Finger Release: Ambulatory Surgical Center vs. Procedure Room. Medical Student Research Symposium (2025).
5. Kronlage, S. C., Lomis, M. J. & Whitaker, E. A. Clinic Carpal Tunnel Release Surgery Outcomes and High-Value Care. Cureus 15, e42254. DOI: 10.7759/cureus.42254
6. Staff. 5 Hand Surgery Trends in Ambulatory Surgery Centers. Becker’s ASC https://www.beckersasc.com/asc-news/5-hand-surgery-trends-in-ambulatory-surgery-centers/ (2012).
7. Rhee, C. et al. Surgical Site Infection Surveillance Following Ambulatory Surgery. Infect Control Hosp Epidemiol 36, 225–228 (2015). DOI: 10.1017/ice.2014.23
8. Operater. Peripheral Nerve Blocks for Outpatient Surgery. NYSORA https://www.nysora.com/topics/sub-specialties/outpatient/peripheral-nerve-blocks-outpatient-surgery/ (2018).
9. Klein, S. M. et al. Peripheral nerve block techniques for ambulatory surgery. Anesth Analg 101, 1663–1676 (2005). DOI: 10.1213/01.ANE.0000184187.02887.24
10. Salinas, F. V. & Joseph, R. S. Peripheral Nerve Blocks for Ambulatory Surgery. Anesthesiology Clinics 32, 341–355 (2014). DOI: 10.1016/j.anclin.2014.02.005
11. Novak, M., Blough, J., Falola, R. & Czerwinski, W. Enhanced Recovery After Surgery: Standardized Postoperative Instructions in Hand Surgery. Hand (N Y) 18, 868–874 (2023). DOI: 10.1177/15589447211065075
12. Joshi, G. P. Enhanced recovery pathways for ambulatory surgery. Curr Opin Anaesthesiol 33, 711–717 (2020). DOI: 10.1097/ACO.0000000000000923
13. Marley, R. A. & Swanson, J. Patient care after discharge from the ambulatory surgical center. J Perianesth Nurs 16, 399–417; quiz 417–419 (2001). DOI: 10.1053/jpan.2001.28891