Enhanced Recovery After Hernia Repair

Abstract

Enhanced recovery after Surgery (ERAS) protocols focus on several components. A multidisciplinary team works on a multimodal approach to resolve issues that might delay recovery, based, as much as possible on scientific, evidence-based protocols in an attempt to change patient management and improve patient reported outcomes. Pre-operative measurements to improve recovery include e.g. smoking cessation, weight loss, diabetes optimization, nutritional optimization and prehabilitation. Intra-operative management mainly focuses on the principles of the WHO guidelines for SSI prevention, including skin preparation and decolonization protocols, perioperative antibiotics and improving postoperative intestinal function. The important post-operative components of ERAS highlight multimodal pain control, early mobilization and the use of abdominal binders. Another important item is the early enteral feeding during recovery to obtain the best outcomes. To improve overall quality of care in hernia surgery, these issues are essential to address in daily practice.