Enhanced Recovery after Surgery (ERaS)

Enhanced Recovery After Surgery refers to restoring the normal body functions of eating, breathing and moving as quickly as possible after surgery. This has been shown to minimise complications, shorten length of hospital stay and improve return to normal activity levels. It is supported by a great deal of research publications.

ERaS involves preoperative, intraoperative (in theatre) and postoperative components. The main phases where patients can make a difference is in the pre- and postoperative phases.

Preoperative ERaS principles include:

• Weight loss if overweight (BMI > 25).
• Improved fitness: ‘training’ for your surgery by walking each day to improve your heart and lung function.
• Stopping smoking.
• Decreasing alcohol intake.
• Optimisation of any chronic medical conditions.

Postoperative ERaS principles include:

• Eating: starting water and other fluids as soon as possible.
• Breathing: sitting upright out of bed; deep breathing exercises and coughing every hour.
• Moving: getting up and moving, with physio assistance, if required. The aim is to be walking independently on the day of surgery, then increasing your mobility level every day until discharge.