Análise da implantação do Serviço de Pequenas Cirurgias e Procedimentos na Atenção Primária

Abstract

Introduction The performance of minor surgical procedures within Primary Health Care (PHC) is outlined in the National Primary Care Policy guidelines, yet its practical implementation remains limited in many Brazilian municipalities. In the Ibitiúva district of Pitangueiras-SP, residents have historically faced difficulty accessing these services, undermining local problem-solving capacity and overloading specialized care. Reasons: Introducing minor surgical procedures at the PHC level aims to broaden the population’s access to definitive care, shorten diagnostic intervals—especially for suspected cutaneous neoplasms—avoid unnecessary referrals, and reduce costs to the health system, thereby reinforcing the principles of comprehensiveness and continuity of care. Theorical Basis: According to Ordinance No. 2,436/2017, family and community physicians are authorized to perform minor surgical procedures in PHC settings. National and international studies show that this practice helps shorten waiting lists, optimize resources, yield low complication rates, and boost user satisfaction, all while strengthening the therapeutic bond and care longitudinality. Objectives: This study analyzes the real-world experience of a Médicos pelo Brasil fellowship physician performing minor surgical procedures between 2024 and 2025. Specific aims are to: Describe patients’ epidemiological profile; Identify the main procedures carried out; Quantify referrals to specialized care; Measure waiting times between indication and procedure; Document challenges encountered during service implementation. Methodology: A retrospective, descriptive study was conducted based on 103 patients seen at the Ibitiúva Family Health Strategy unit from February 2024 to March 2025. Data were extracted from electronic medical records, including age, sex, ASA classification, procedure type, waiting time, and post-procedure referral needs. Expected Results: We anticipate a significant rise in local access to procedures such as skin lesion biopsies, ear lavages, and excisions of benign lesions. We also expect a marked decrease in referrals to specialized care and shorter intervals between clinical suspicion and definitive diagnosis—thereby enhancing PHC resolutiveness and lowering care costs. Final Considerations: The Ibitiúva experience highlights PHC’s potential to safely conduct minor surgical procedures, yielding gains in efficiency, accessibility, and relief for specialized services. Scaling this practice elsewhere will require investments in infrastructure, technical training, and institutional support—underscoring PHC’s role as the entry point and coordinating axis of health care.