La crisis mundial desatada por la pandemia de coronavirus redefinió la modalidad de atención en salud y así también en cirugía. La Cirugía Mayor Ambulatoria se estaba desarrollando como una modalidad de trabajo que resultaba eficiente al sistema de salud, pero no lograba ponerse en el centro de la escena. En este momento, parece ser el modelo ideal para evitar las infecciones por Covid-19 y ante esta oportunidad, potenciar su desarrollo de manera definitiva. El Servicio de Cirugía General del hospital de Clínicas Nicolás Avellaneda de Tucumán, presenta una unidad de CMA integrada con amplia experiencia la cual sirvió como soporte para dar respuesta a la necesidad de resolver las listas de espera quirúrgica, evitar que patologías simples progresaran a complicadas, trabajar con bajos costos y minimizar riesgo de contagios durante el periodo de pandemia en nuestra provincia. Presentamos los pasos y las precauciones tomados para rediseñar y adaptar la modalidad diaria de trabajo.

Background: Major ambulatory surgery is defined as therapeutic or diagnostic surgical procedures, performed under general, regional or local anesthesia, with or without sedation, which require shortterm postoperative care, and therefore do not require hospital admission Objective: The aim of this study is to analyze the experience of the same day unit integrated to the Department of General Surgery and Gastrointestinal Surgery at Hospital de Clínicas Pte. Avellaneda in San Miguel de Tucumán between January 2014 and December 2018. Material and methods: We conducted a descriptive and retrospective cross-sectional study. Patients between 14 and 75 years were included. Data were collected from a prospective database implemented for the beginning of a pilot experience. Results: A total of 3827 surgeries were performed; 2327 corresponded to MAS procedures; 1514 patients were women, and aged ranged between 45 and 54 years. The surgical procedures corresponded to laparoscopic cholecystectomy, abdominal wall defects, perianal diseases and combined procedures. Quality indicators: the cancellation rate, which indicates the percentage of patients who did not attend the day surgery unit, and the rate of procedures suspended due to issues associated with patient selection and infrastructure, showed a statistically significant reduction between 2014 and 2018. Unplanned repeated surgery rate was 0.35% in 2018, and unplanned admissions and readmissions decreased to 1.6% and 1.07%, respectively, in 2018. Major complications occurred in 13 patients and 39 patients presented minor complications. Patient’s satisfaction was 99.5%.. Conclusion: MAS is a safe process, with low rate of complications. .