Journal
JOURNAL OF MINIMALLY INVASIVE GYNECOLOGY
Volume 26, Issue 2, Pages 327-343Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jmig.2018.12.010
Keywords
Enhanced recovery; ERAS; Gynecology; Gynecologic surgery; Fast track; Same-day surgery
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Enhanced recovery after surgery (ERAS), or fast-track protocol, aims to minimize the physiologic stress of surgery and optimize the rehabilitation of patients. However, there is limited data in obstetrics and gynecology. We reviewed the published literature on ERAS programs in gynecology to evaluate the outcomes and potential key elements for a successful program. Fifty studies were evaluated. We recommend preoperative counseling to the patient, no bowel preparation, an opioid-sparing multimodal approach to pain management, goal-directed fluid management, minimally invasive surgery when possible, and early mobilization and feeding. This is a multidisciplinary team effort and requires active patient participation in the process. (c) 2019 Published by Elsevier Inc. on behalf of AAGL.
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