Pilot Study: Utilization of Telemedicine and Enhanced Recovery after Surgery in Adolescent Metabolic and Bariatric Surgery

Abstract Introduction: Principles of Enhanced Recovery after Surgery (ERAS) have been successful in improving adult perioperative care. We have previously shown the feasibility of telemedicine in pediatric postoperative care. This study assesses the effectiveness of telemedicine and ERAS (TERAS) to facilitate early discharge while improving perioperative care of adolescent metabolic and bariatric surgery (AMBS) patients. Method TERAS principles included: minimization of fasting, emphasis on non-narcotic analgesia, minimization of indwelling catheters, aggressive patient mobilization and close interval telemedicine visit. Length of stay (LOS), narcotic use, perioperative complications, ED visits and readmissions were compared between enrolled patients (n = 8) and historic controls (n = 10). Caregiver satisfaction with telemedicine was surveyed. Results The study group showed shorter LOS and less narcotic use than the control group with comparable pain control. There was no difference in ED visit, readmission or complication rates. Every caregiver was very satisfied with the telemedicine visit and stated they preferred it over an in-person visit. Conclusion Implementation of the TERAS protocol in AMBS may result in shorter LOS and decreased narcotic use. TERAS protocol appears to be feasible and has the potential to be beneficial for AMBS patients.