Ambulatory, or outpatient, surgery is applicable to relatively few chapters in this Atlas. However, the repair of inguinal, femoral, and small umbilical hernias, breast biopsies, excision of skin tumors, and many plastic procedures are commonly performed in an ambulatory setting. In addition, many gynecologic procedures as well as certain orthopedic, otolaryngologic, and other procedures are performed in this area. The decision for or against ambulatory surgery may depend on the facilities available, as well as on the presence of an in-house anesthesiologist, recovery room, and observational unit. If all of these are available, some surgeons will also perform minimally invasive or laparoscopic procedures. Many patients tend to feel reassured by plans for ambulatory surgery, which in the majority of instances does not involve hospital admission. Obviously, the guidelines for this approach may well be altered by the patient's age and any changes in physical status.