Enhanced recovery after surgery in bariatric and metabolic surgery

Enhanced recovery after surgery (ERAS) protocol is an extensive, evidence based, multimodal and multidisciplinary protocol for surgery. ERAS aims to enhance pre-intra and postoperative physiology and optimization of recovery after surgery. The concept of this approach showed us, multidisciplinary instrument integrating several perioperative elements, with the use of minimally invasive surgery, could be adopted various surgical procedures. Recently, principles of these protocols and their advantages are extended into bariatric and metabolic surgery. In this review, we summarize the components of ERAS protocols for bariatric and metabolic surgery according to ERAS Society guidelines and present the evidence on the emerging role of ERAS principles in obese patients. Many recent trials have evaluated ERAS protocols for bariatric surgery. Studies demonstrate that using ERAS protocols requires evidence- based modifications in all perioperative phase. The benefits of ERAS in this group of patients, including decreased length of hospital stay, rapid patient turnover, shorter operating room times and lower healthcare costs have been well demonstrated repeatedly. Despite the role of ERAS protocols in bariatric surgery is in its early phase, literature supports its role in improving perioperative outcomes compared with conventional care. Evidence-based protocols and multidisciplinary teamwork seem to be the key factors for success in ERAS.