Enhanced recovery in elective gynaecological surgeries

Background: Enhanced Recovery after Surgery [ERAS] program is an evidenced based model of care for elective surgery that enables patient to recover more quickly and have shorter hospital stay. Fast track surgical program allows early discharge with low risk of readmission and improved outcomes. Method: This study was prospective non-randomised observational study and was conducted in the department of Obstetrics and Gynaecology, Berhampur, Odisha from October 2015 to September 2017. A total of 100 cases were included in the study. Criteria of inclusion was patients undergoing elective gynaecological surgeries for benign conditions which included TAH by small transverse incision (<6cm), NDVH, LAVH/TLH. Results: In our study most of the patients presented with heavy menstrual bleeding. The most common clinical diagnosis in patients who underwent hysterectomy was fibroid uterus. In our study the commonest surgical method was abdominal (49%) followed by vaginal (32%) & laparoscopically (19%). There was significant decrease in duration of hospital stay when compared with the duration of hospital stay in conventional abdominal hysterectomy by other studies. Conclusion: According to this study, no surgical technique has shown to eliminate postoperative morbidity, strong consideration must be given to minimally inavasive surgeries and ERAS pathways which may lead to major reduction in undesirable sequale postoperatively and results in faster convalescence and improved recovery.