Foundation and early history of the International Association for Ambulatory Surgery
1995 - 2001
The initiative to establish Ambulatory (Day) Surgery in the International Forum can be trace to the First European Congress on Ambulatory Surgery, which was held in Brussels, Belgium, 8-9th March 1991, and organised by Claude de Lathouwer, President, Belgian Association of Ambulatory Surgery. This was a success, with 600 delegates from 25 countries, and it was decided to hold another conference in 1993.
The Second European Congress on Ambulatory Surgery was held in Brussels, 19-20th March 1993, during which a group of representatives from interested nations held an informal meeting, convened by Claude de Lathouwer, to consider the formation of an international association dedicated to ambulatory surgery. The proposal attracted strong support and it was agreed that more formal meetings of the group of interested representatives should be organised.
A further meeting was held in London (UK), 17-18th September 1993, and the interested group became the Foundation Committee, which unanimously agreed that the International Association for Ambulatory Surgery should be formed. Claude de Lathouwer was elected Convenor. Member nations of the Foundation Committee were: Australia, Belgium, France, Germany, Netherlands, Italy, South Africa, Spain, Sweden, Switzerland, United Kingdom and the United States of America.
It was also decided that the Association should be registered in Brussels and this would require preparation of a Constitution. Ambulatory Surgery, a journal dedicated to ambulatory (day) surgery practice had been commenced in 1992, with Paul Jarrett (UK) as editor. The first issue was launched in March 1993 during the Second European Congress. It was agreed that Ambulatory Surgery would become the official journal of the Association.
The next meeting of the Foundation Committee was held in Orlando (USA), 9-10th May 1994, and this was almost entirely dedicated to drawing up the Constitution. Claude de Lathouwer agreed to prepare a draft Constitution. It was also agreed that the next conference should be held in Brussels, 14-15th March 1995, as the First International (Third European) Congress on Ambulatory Surgery.
The Foundation Committee met again on 14th March 1995 during the First International (Third European) Congress on Ambulatory Surgery and the Constitution was adopted. The following day, 15th March 1995, formation of the International Association for Ambulatory Surgery was announced at the Congress by Claude de Lathouwer, who had been elected Foundation President. A Foundation dinner was held the same night.
The main objectives of the Association are:
- to serve as an international multi-disciplinary forum for the exchange of information and advancement of ambulatory surgery
- to promote education and research
- to establish guidelines and
- to act as an advisory body to all interested parties for the development and maintenance of high standards of patient care in ambulatory surgery facilities.
Claude de Lathouwer offered to locate the Secretariat of the Association at his office in Brussels and this was gratefully accepted by the Executive, which was formed from the Foundation Committee. The efforts of Claude de Lathouwer in organising the Congresses, convening meetings of the Foundation Committee and preparing the Constitution of the Association, were acknowledged by the Executive. He also initiated the important project of collecting international data on ambulatory surgery practice in conjunction with the Organisation for Economic Co-operative and Development (OECD). This data has been published and continues to be updated. The Constitution provides that full membership representatives of affiliated nations form the General Assembly, which elects the Executive, and two meetings are held each year. The President and the Executive are elected for two-year terms.
The primary challenge for the new Association was to increase membership and to establish Ambulatory Surgery as the pre-eminent International Journal on Ambulatory Surgery Practice. Paul Jarrett (UK) and Tom Ogg (UK) were tireless in their successful efforts in these projects.
The Second International Congress on Ambulatory Surgery was held in London (UK), 14-15th April 1997. This was a successful Congress with 1,100 delegates from 36 countries. The General Assembly/Executive held meetings during the Congress and Paul Jarrett (UK) became President. He initiated the project of preparing international definitions of ambulatory (day) surgery, and co-opted Australia to assist. Membership of the Association steadily increased.
The Third International Congress on Ambulatory Surgery was held in Venice (Italy), 25-28th April 1999, and was a most successful event with 2,311 delegates from 41 countries. Tom Ogg (UK) became President. His successful efforts in attracting major sponsorships for the Association significantly contributed to establishing its financial strength. He also prepared the Bid manual for nations to apply to host international congresses. He identified quality expansion of day surgery as the main objective with increasing effort to expand membership to Asia Pacific, South America and Eastern Bloc nations. The preparation of International Definitions was protracted, however these were finalised in October 1999 and were published in Ambulatory Surgery with translations in 11 languages. The important project of developing an education process for ambulatory surgery was established with Italy being delegate the responsibility of preparing a Thematic Network for distance ambulatory surgery education. A Skymed Pilot Utilisation Plan was introduced September 2000 and preparation of a course of lectures, video tapes and data will then be presented on the internet for world wide retrieval.
Financial management of the Association was delegated to France and the excellent efforts of the Treasurer, Gerard Parmentier, have been recognised by the Executive.
The Association was now well established and continued to expand. The Congresses have been very successful with increasing numbers of delegates. The Third International Congress on Ambulatory Surgery was held in Geneva, Switzerland, 22-25th April 2001.
At the end of the year 2000 the following countries were affiliated:
Full membership - Australia, Austria, Belgium, Denmark, France, Germany, Hong Kong, Italy, Netherlands, Norway, Poland, Portugal, Spain, Switzerland, United Kingdom, United States of America
Associate members - Australia, Chile, Italy, Hungary, South Africa, Romania
Individual members - Canada, Egypt, Greece, Latvia, Ukraine.
This unique multi-disciplinary organisation will continue to work for the expansion of high quality ambulatory surgery world-wide, especially to those countries that have not yet developed this important procedural service. The achievement of its objectives largely depends on the development of excellent communication channels and to this end this website was born - www.iaas-med.com.
The Association, in its first five years, had become soundly established, both functionally and financially. However the years to follow proved to be more challenging and difficult.
The 4th International Congress on Ambulatory Surgery was held in Geneva (Switzerland), 23rd-25th April 2001. Although the number of delegates was smaller than previously (612), this was a very successful Congress and Lindsay Roberts, Australia, became President.
The Office, which had been located in Brussels (Belgium) for six years, closed in 2001 and was relocated to the building of the Royal College of Surgeons of England, London - a process which took three years to finalize during which the secretariat operated out of -temporary offices- firstly in Sydney, Australia and then Amsterdam, The Netherlands.
On 11th September, 2001 the world was -shaken- by the Islamic terrorist attack on the Twin World Trade Centre towers in New York, and on the Pentagon in Washington in the U.S.A. and the world hasn't been the same since.
The Association's Executive Committee was scheduled to hold a meeting in Wurzburg, Germany on 15th September, 2001 and the President, Lindsay Roberts, directed that this arrangement should proceed, notwithstanding the risks and difficulties imposed on members to attend. The meeting was attended by seven (of a total 11) members and was very productive, although a personal tragedy was to follow. After the meeting, one of the members, Professor Mare Claude Marti from Switzerland, travelled to Egypt for a holiday but suffered a major heart attack from which he did not survive - a very sad loss for his family and the Association.
The prime objectives of the Association to expand its membership and prepare standards for high quality, safe ambulatory surgery practice continued through this troubled period. A major achievement, largely due to the dedicated efforts of Gerard Parmentier (France), was the computerized recording of International Definitions of Ambulatory Surgery in 11 languages, which have been included on the Association's website.
The 5th International Congress on Ambulatory Surgery was held in Boston (U.S.A.), 8th-12th May, 2003. This successful conference of 1336 delegates was notable for its very large trade exhibition of 198 companies. At this time, Dick de Jong, The Netherlands, became President.
Since its foundation, the International Association for Ambulatory Surgery has been registered in Brussels, Belgium, requiring that its by-laws be written (French and English languages) in strict accord with Belgian law and signed by the King. Relocation of the Association's Office and formation of the European Union necessitated re-writing of these by-laws, which was a complex and prolonged process for the President, Dick de Jong, assisted by several other members of the Executive.
The development of high standards of safety and quality in ambulatory surgery centers/units is a prime aim of the Association. Standards for selected aspects of ambulatory surgery had been prepared, however the subsequent publication of a book covering all aspects of ambulatory surgery practice was a most meritorious achievement of the Association. Paulo Lemos, Portugal, was the driving force and coordinator of this project, and his efforts to complete the book "Day Surgery - Development and Practice" (2006) in 12 months were acclaimed by all.The 6th International Congress was held in Seville (Spain), 24th-27th April, 2005. This successful conference of 1090 delegates will be long remembered for its three hour 'Spanish lunches' each day and the spectacular Congress dinner featuring a traditional Spanish horse show. Ugo Baccaglini (assisted by Carlo Castoro) became President.
Ambulatory surgery has continued to expand in most developed countries around the world and in some of these has reached levels that were never envisaged when the Association was founded in 1995 e.g. 80%-85% in the United States of America, 70%-75% in the United Kingdom. In many countries levels of 50%-60% have been achieved while in others the expansion has been much slower. In most countries ambulatory surgery is carried out in hospitals, some of which have dedicated units, while in others large numbers of freestanding centers have been built e.g. United States of America and Australia - both models are supported.
The Association in collaboration with the European Observatory on Health Systems and Policies has prepared a Policy Brief for the expansion of day surgery in Europe, although it would be equally applicable to any country. The project was initiated by Carlo Castoro and Ugo Baccaglini, Italy, and this excellent document entitled "Day Surgery: Making it Happen" will not only assist the expansion of day surgery, especially in those countries where this high quantity, cost effective surgical service is in its early stages of development, but will also enhance the status of the Association as a world authority on all aspects of day surgery. The Policy Brief will be launched at the 7th International Congress on Ambulatory Surgery, Amsterdam, 16th-18th April 2007.
"Ambulatory Surgery" has been the official journal of the Association for 10 years, edited by Paul Jarrett, United Kingdom, however an important change is that in future the journal will become multidisciplinary and published electronically on the Association's website.
During the Executive Committee meeting in Amsterdam (The Netherlands) on April, 15th ,2007, Claus Toftgaard from Denmark was elected as the new President, while Paulo Lemos from Portugal became the new President-elect. Secretary and treasurer still stayed in the hands of Bob Williams from U.S.A. and Jacky Reydelet from Germany. Dick De Jong welcomed the GA members to Amsterdam. Application for membership was filled in by Finland (Finnish Ambulatory Anesthesiologists Association) and also Iceland was said being interested in joining the IAAS: here it was a group of ambulatory surgery care providers that would like to apply.
Paul Jarrett announced the ex officio membership of Beverly Philip from Boston, U.S.A., being one of the editors of the Ambulatory Surgery Journal that from then on was to follow on the web-site in an electronic version. The IAAS book "Day Surgery - Development and Practice” (an idea from Paulo Lemos), was been printed in 5500 copies and distributed to twenty different countries and was also made available electronically on the IAAS web-site as was the Policy Brief “Day Surgery: Making it Happen “by Carlo Castoro from Italy. This later document was distributed amongst Health Care managers, administrators and politicians with the aim of explaining the importance of the ambulatory surgery concept.
A new and important idea was launched by Claus Toftgaard: an international survey to detect the trends and evolution in the use of ambulatory surgery in the different countries - using figures delivered by the membership countries.
Another new initiative concerning the evaluation of Day Surgery and impact on quality and costs, was presented by Ugo Baccaglini, Carlo Castoro (with the most appreciated help of Pascale Camporese), all from Italy: IAAS should come in contact with the European Public Health Executive Agency (PHEA). It was agreed to reflect on that topic and to see how IAAS could participate and with which financial risks.
On September 15th, 2007 an Executive committee (ExCo) meeting is organized in Ludwigsburg (Germany).
Next ExCo and GA meetings were scheduled in Copenhagen, 25th -26th April 2008. For the first time IAAS was confronted with the withdrawal of a member: Poland. The reason was a financial one.
The 8th International Congress on Ambulatory Surgery took place in Australia, Brisbane, 5th – 9th July 2009. The total number of paying participants was 724 and most of them were from Australia and New-Zealand. 65 % of participants were nurses. An important delegation from China and India were also present. The Nicoll lecture was given by Jill Solly from UK. To control the IAAS budget Paulo Lemos developed new travel reimbursement criteria and it was stated to see for economically interesting places for ExCo and GA meetings. Carlo Castoro and Ugo Baccaglini are asked to make a contract with the EU (European Union) for working together. Paulo Lemos was the new president and Carlo Castoro was nominated as president-elect. Aesculape was welcomed as a corporate member and Sudan expressed interest in joining. Paulo Lemos introduced a multi-purposes document, to be used in soliciting new individual, associated or corporate members. For practical reasons the official office was moved to Ghent, Belgium. To facilitate the organisation of the next 2011 Congress in Copenhagen (Denmark), organized in co-participation with ICS (Congress Organizer), Dick De Jong revised the Bid Book. At the same meeting it was decided to plan the 2013 Congress in Budapest (Hungary). For Lindsay Roberts from Australia, it was the last meeting and he was replaced by Wendy Adams, also from Australia. Lindsay was thanked for the work done for IAAS.
The next ExCo meeting was on November 21st, 2009, but more important was the combined ExCo and GA meeting in Lisbon (Portugal), on May, 8th 2010. Another ambulatory surgery association from Italy asked for full membership: after discussion it was stated that only one association per country can be an IAAS member. Other associations may apply for an associate or a corresponding membership. At this time Hugh Bartholomeus from Australia attempted to develop a combined Day Surgery organization between Australia and New-Zealand. Sadly this did not succeed . On the other hand a project to conduct joint meetings with EU Commission projects, is accepted gratefully. This made an important saving on travel and accommodation costs. India was proposed as a new full member and Dr. Langberg da Rosa from Peru as an individual member. Mohamed Gamal from Hungary will contact the neighbor countries of Hungary to join the IAAS. The ExCo candidacy rules were revised as was the travel reimbursement policy. There was also a proposal from the Danish Congress Organizer ICS to continue working together with IAAS for organizing following congresses: this was considered but the General Assembly decided against linking with a single conference organiser.
The 9th International Congress on Ambulatory Surgery was organized in Copenhagen, Denmark from May, 8th – 11th , 2011. 884 (686 paying) delegates were registered. Organization was in good hands with the Scandinavian countries all together and ICS as Congress Organizer. ExCo meeting and GA meeting took place in the Bella Centre: Carlos Castoro from Italy is the new President and Ian Jackson from UK, is chosen as president-elect. India is accepted as full member and AAAHC (Accreditation Association for Ambulatory Health Care, USA) as friend of the organisation. There were contacts with Brazil (individual member) and Mexico and also South Africa showed interest, but no further news. In the meantime, Ian Jackson from UK prepared the IAAS website for downloading the old versions of the Ambulatory Surgery Journal and Jost Broekelmann from Germany started with a Newsletter to spread news to member organisations, potential members, doctors, nurses, politicians and all people interested in the AS concept. Concerning the Journal and to stimulate the writing of articles, a 10% discount on the membership fee was installed for countries with 2 articles published that year.
On October 21st , 2011, during the ExCo meeting in Budapest, the president, Carlo Castoro from Italy, announced a project with the European Union: www.daysafe.eu. Ian Jackson (UK) showed us the increasing number of visitors of our website. We had also meetings with GSK and MSD to try to start common initiatives and Mohamed Gamal from Hungary launched the idea of Teach the Teacher courses (TtT).
In Porto (Portugal) during the ExCo meeting on May, 12th 2012, while discussing how to organise our next Congresses it was decided not to opt for daily professional help for secretary and treasurer but to propose a local professional congress organiser and ask them to install an international scientific committee and an international organising committee with IAAS - GA members. GA members should have a speech at the congress to receive free nights. Concerning working points, 3 pillars were proposed:
- TtT project,
- dissemination of the AS concept by Journal, Newsletter, website,
- networking via congresses, contacts with LSE (London School of economics), OECD (Organisation for Economic Co-Operation and Development) and European projects ( for example DSDP , Day Surgery Data project).
At this stage 726 people were subscribing for the Newsletter and Journal, 5 countries were given a rebate of 10 % for writing articles in the Journal and expansion was realised via individual membership of Boguslaw Kompf (Poland), Jelena Petrovic (Serbia), Pierre Rosset (Switzerland) and Florentina Cadariu (Rumania).
On the ExCo meeting on October, 27th 2012 in Budapest, Japan asked to join the IAAS. The first TtT (Teach the Teacher) course was planned for Budapest with following aims:
- to strengthen the relations with Eastern European IAAS members
- to contribute to the introducing of the culture of Day Surgery practice.
The final meeting of the DSDP project was held in Padua, Italy (August, 2012) and 2 new projects were proposed to contribute with: Day Safe Project (aim: improve patient safety and quality of hospital care) and Day Simple Project (aim: providing evidence on DS performance by comparative analysis and benchmarking). In the meantime we see 180 – 400 hits/week on our website.
During the 10th International Congress on Ambulatory Surgery in Budapest from May 5th – 8th, 2013, Japan (Japanese Short Stay Surgery Association, JSSSA) and China (China Ambulatory Surgery Association, CASA) are welcomed as new full members. Furthermore there was interest for individual membership from Belarus, Greece and Palestine. Number of delegates in Budapest was 710 with 248 Hungarians and 30% of participants were nurses. Ian Jackson from UK started as the new president with Mohamed Gamal from Hungary as the new president-elect. Also in Budapest the first TtT course was run.
The ExCo meeting in Timisoara (Romania) on September, 14th 2013 was a joint meeting with the European project Day Safe and Agenas (project led by Pascale Camporese). During 2013 and 2014, thanks to the work of Carlo Castoro from Italy, we were lucky to receive an European Operating Grant; the funding received supported our work program i.e. the organisation of workshops (TtT courses) in Budapest (Hungary) in May 2013, in Timisoara (Romania) in September 2013, in Kolarova (Slovakia) in November 2013 and in Belgrade (Serbia) in December 2013. For this purpose, the Day Surgery Handbook (available on the IAAS Website) was translated in Hungarian, Romanian and Serbian. IAAS could also send 2 doctors to a DS center in Norway and in Porto (exchange program).
Barcelona (Spain) was the place to be for the ExCo and Ga meeting on May, 3rd , 2014. Our Spanish friends from ASECMA had the intention to organise the 11th International Congress on Ambulatory Surgery in Barcelona, Spain, in joint venture with the organisation of the Paniberico Congress i.e. the Congress of the Iberic Peninsula (that contains Spain and Portugal). In 2014 two other TtT courses were organised in Athens (Greece) in October 2014 and Zagreb (Croatia) in December 2014. Concerning expansion of the Association, one surgeon from Mongolia showed interest in joining as an individual member, but otherwise we remain without any news. Furthermore we received individual application forms from Iceland, Chili and Malta.
On November, 1st, 2014 we had an ExCo meeting and a joint meeting with Prof. Allister McGuire and his team from the London School of Economics (LSE). Together with LSE leadership, the IAAS participated as a second Proposer, in an European Project called European Network of Ambulatory Surgery Pathway (ENAS) that resorts under COST (European Cooperation in Science and Technology (www.cost.eu). COST is Europe’s longest-running intergovernmental framework for science and technology cooperation. The advantage for IAAS would be that travel costs can be refunded by this project for those members of the IAAS who are participating. In this meeting we made contact with Gaetan Delafortune from the OECD, who was also interested in working with IAAS.
To prepare the participation to the COST project we had a meeting in London on December, 19th 2014 with Prof. Allister McGuire and a delegation of IAAS: unfortunately the proposal of LSE was not retained for funding (03/2016).
Barcelona was chosen for the 11th International Congress on Ambulatory Surgery, May 10th – 12th , 2015. Participation of 637 delegates with 50% of them from Spain. Mohamed Gamal started as the new President and Beverly Philip from Boston, USA was appointed as the president-elect. We had to say farewell to some important and already long time working delegates: Jost Broekelmann, Paulo Lemos, Wendy Adams and Raafat Hannallah. They were gratefully thanked for their contribution to the Association. From Australia the question came if they could participate with 2 associations, i.e. ADSNA (Australian Day Surgery Nurses Association) and ADSC (Australian Day Surgery Council). This was accepted by the GA and they will be represented by one delegate for each association. Columbia (Sociedad Colombiana de Anesthesiologia Y Reanimacion, SCARE) was appointed and accepted as a new full member. The most important discussions were about the financial situation and it was decided to increase the contribution with 2% for the next two years. Because of 2 applications (China and France) for organising the next Congress in 2017, the GA proposed to organise a joint regional (European) Congress with AFCA (Association Française de Chirurgie Ambulatoire) and IAAS in Paris, France, in January 2016 and the 12th International Congress in Beijing, China in May 2017.
For the AFCA – IAAS regional Meeting in January, 27th – 29th , 2016 approximately 700 delegates were registered.
At the end of the year 2016 the following countries were affiliated:
Full membership : Australia (ADHA and ADSNA), Belgium, China, Columbia, Denmark, Finland, France, Germany, Hungary, India, Italy, Japan, The Netherlands, Norway, Portugal, Spain, Sweden, United Kingdom, United States of America (ASCA and SAMBA).
Associate members : none
Individual members : Poland, Serbia.
Friend of the Association : Accreditation Association for Ambulatory Health Care (AAAHC, USA).
Council of Presidents
International Association for Ambulatory Surgery
Luc Van Outryve, treasurer, September 2016