ERAS Surgical Care: Gynecologic Cancer

What is ERAS?

ERAS is a program to improve surgical quality. The guidelines put the focus on the patient. They encourage and empower you to be an active partner in your care.

The goal is to provide a smoother and safer surgical experience. Here’s how:

• Reducing complications

• Shortening hospital stays

• Improving outcomes

By achieving these goals, ERAS can also help lower healthcare costs.

A group of experts called the ERAS Society first developed this approach for colon surgery. The guidelines were so successful that the ERAS Society went on to create guidelines for other procedures, such as gynecologic surgery. Today, healthcare providers worldwide have adopted the ERAS approach.

What's in the guidelines for gynecologic surgery?

ERAS strategies start as soon as you decide on surgery and continue after discharge. Some ERAS guidelines are shared across various procedures. But guidelines vary depending on the kind of surgery you’re having. Guidelines for gynecologic surgery include:

• Patient education. Your healthcare team will tell you all about your surgery. They will help you understand what will happen during and after it. They’ll also let you know how to get ready for surgery.

• Nutrition. Your healthcare team will let you know about foods you should eat before surgery to help you heal and get better faster. You will likely be able to eat solid foods up until 6 hours before surgery. And you will likely be able to have clear liquids up until 2 hours before surgery. Your team will make sure you get enough fluids during your surgery. They might let you eat and drink soon after surgery to help promote recovery.

• Exercise. Certain kinds of light exercise and activity before surgery might help you get better faster.

• Pain management. Your healthcare team might try to manage your pain before surgery. This can help you to have less pain after your surgery. That also means there will be less need for pain medicines. Your team might use different medicines and ways of relaxing to control your pain after surgery. The goal is to limit the use of opioid pain medicines.

• Surgical method. ERAS advises using the least invasive surgical option. This may mean using laparoscopic surgery or having a vaginal hysterectomy. Doing surgery with small cuts (minimally invasive surgery) can lessen your pain and help you heal quicker.

• Tubes and drains. ERAS advises avoiding intraperitoneal drains when possible. They also advise using urinary catheters for the shortest time possible.

• Movement. Your healthcare team might want you to start moving as soon as you can after surgery. This can help prevent problems and help you heal.

When healthcare providers follow ERAS, it often means you get better faster. That means you can get back to your everyday activities quicker. There are other ERAS guidelines specific to gynecologic surgery. Talk with your team about ERAS guidelines related to your surgery.