Enhanced Recovery after Surgery
Enhanced Recovery After Surgery is a modern approach to perioperative care of surgical patients that aims to reduce surgical stress and thus improve recovery of patients. Enhanced recovery protocols aim to ensure that patients are in the best possible conditions before surgery, receive the most optimal surgery and anesthesia and postoperative care. Implementation of enhanced recovery protocols relies on the close collaboration of all specialists participating in the perioperative process, as well as of the actual patients and their relatives. The concept of enhanced recovery after surgery was introduced in the 1990s by professor Henrik Kehlet. The original protocols were written for colorectal surgery. The protocols have since been shown in several randomized clinical trials and meta-analyses to reduce postoperative complications, length of hospitalization, improve clinical recovery parameters and to reduce hospital costs. Enhanced recovery protocols have now been developed for a wide range of surgical fields, including foregut surgery, pancreatobiliary surgery, gynecological surgery and urology. In 2015, in a further attempt to improve postoperative outcomes, the Intensified Recovery in Abdominal Surgery (Via RICA) protocol was developed and published. Via RICA is a detailed enhanced recovery protocol for abdominal surgery based on interdisciplinary consensus. An update for the Via RICA has since been developed, which includes several other surgical disciplines other than abdominal.