Implementation of an Enhanced Recovery After Surgery protocol for sleeve gastrectomy at the 5-year mark and its association with perioperative outcomes

Abstract

Enhanced Recovery After Surgery programmes combine efficient perioperative care pathways with evidence-based strategies to improve physiological readiness for surgery. In total, 220 patients undergoing laparoscopic sleeve gastrectomies in 2018 (pre-Enhanced Recovery After Surgery) were retrospectively compared with 143 patients undergoing laparoscopic sleeve gastrectomies in 2023-24 (Enhanced Recovery After Surgery) at our institution. Comparisons looked at postoperative length of stay, post-anaesthesia care unit length of stay, opioid usage, postoperative nausea and vomiting, visual analogue pain scores, 30-day readmissions, and mortality rates. The primary goal of this study was to evaluate the association between implementation of our Enhanced Recovery After Surgery protocol at year 5 with postoperative outcomes, with a focus on patient length of stay and opioid usage. Our protocol saw a significant decrease in all variables, with similar readmissions and mortality rates. The bariatric Enhanced Recovery After Surgery protocol implemented at our institution for laparoscopic sleeve gastrectomy improved perioperative outcomes with no increased patient risk.