Life in the laparoscopic fast lane: evidence‐based perioperative management and enhanced recovery in benign gynaecological laparoscopy

Abstract

Key content: Enhanced recovery after surgery (ERAS) protocols aim to shorten the length of hospital stay and expedite recovery, without increasing complications or readmission rates. Implementation of ERAS protocols should be evidence-based, including when applied to pre-admission clinic (including preoperative investigations), fasting, antibiotic prophylaxis, thromboprophylaxis, analgesia, expeditious removal of urinary catheters and early mobilisation. Learning objectives: To understand evidence-based perioperative management of patients undergoing laparoscopic procedures for benign gynaecological indications. To appraise critically the judicious ordering of preoperative investigations. To understand the importance of preoperatively assessing and managing each patient's risk of venous thromboembolism. To understand the key components of perioperative management that decrease surgical site infection(s). Ethical issues: Preoperative patient education is a vital component of perioperative management; written materials should be prepared in languages other than English to enable all patients to benefit from the ERAS approach. A balance must be found between applying ERAS protocols as a checklist to ensure all aspects of patient care have been considered and tailoring those protocols to each patient's individual needs. Copyright © 2021 Royal College of Obstetricians and Gynaecologists