Once the exclusive domain of hospitals, surgery increasingly is done on an outpatient basis at surgical centers that save patients both time and money.

Patients once could only be admitted to the hospital for procedures such as tonsillectomies and hysterectomies.

Today, patients can have such surgeries at outpatient centers.

There are two general surgery outpatient centers in Cape Girardeau: Doctors' Park Surgery Inc., which opened in 1976 but expanded its operations last fall, and Missouri Surgery Center Inc., which opened last October.

In February, Dr. Richard Kies moved his ophthalmology practice to a new building on Mount Auburn Road, which includes an outpatient center where he performs much of his eye surgery.

Doctors' Park Surgery has been around from almost the beginning of the nation's outpatient surgery movement.

In 1975, when Doctors' Park was being planned and built, only 42 such centers operated in the United States.

"This was the first licensed ambulatory surgery center in the state of Missouri," said Ron Wittmer, the president and managing partner of the facility.

Today, there are more than 1,600 such centers nationwide.

"We did about 1,600 procedures last year and we are increasing all the time," said Wittmer.

Kies used to do all of his eye surgery at the two Cape Girardeau hospitals. But he elected to build his own surgery center when he realized many of his patients were going outside the area to have the surgery done at less expensive outpatient centers.

Kies said it isn't only a less expensive option, but outpatient centers also are "less intimidating" to patients.

Kies' surgery center takes up about half of his 13,000-square-foot building, with his office occupying the other half.

Since opening in October, Missouri Surgery Center Inc. has handled 650 surgical cases.

Dr. Gregory Tobin owns the 5,000-square-foot surgery center. The center is housed in Tobin's new medical building, which also houses Tobin's plastic and hand surgery practice.

Tobin said his surgeries account for about 40 percent of the procedures done at the surgery center, with the rest being done by other doctors.

Everything from general surgery to gynecological procedures are performed at the center.

Tobin said there are good reasons for the popularity of outpatient centers.

"You don't have someone meeting you at the door of the facility with a wheelchair, he said. "It's a much more relaxed atmosphere."

Not all surgery is done in outpatient centers.

"Any procedure requiring a stay longer than 23 hours must be done in a hospital," said Tobin.

Doctors' Park Surgery is equipped to keep patients overnight for observation, but most of its patients have surgery and return home the same day.

"Patients come in at 7 or 8 o'clock for surgery. Most patients are gone by 3 or 4 in the afternoon," said Wittmer.

"We do a lot of gynecological surgery," he said.

The surgery center has five operating rooms and 12 recovery beds, and has state-of-the-art surgical equipment, including two lasers.

Wittmer said one advantage of the facility is that families can see the patients much sooner after surgery than is typically the case in a hospital.

Doctors' Park Surgery was formed by a group of doctors, but it has expanded its operations since new ownership took over in June 1992.

The owners are Wittmer and six doctors: Jonathan Foley, Christopher Jung, Frank H. McGinty, Scot Pringle, Walter Schroeder and Paul Thompson.

Wittmer said the surgery center has purchased about $1 million worth of equipment since 1992.

About 45 doctors have surgical privileges at the facility. About 20 of them perform surgeries at the outpatient center on a regular basis.