Impact of enhanced recovery implementation in women undergoing abdominal sacrocolpopexy

Abstract

Enhanced recovery after surgery (ERAS) programs are based on multidisciplinary collaboration and are designed to mitigate the surgical stress response and hasten convalescence. 1,2 ERAS implementation substantially reduces hospital length of stay (LOS), opioid use, and costs while maintaining stable readmission rates and pain scores. 3 Studies regarding ERAS have focused primarily on oncologic procedures in gynecologic and colorectal surgery. 4,5 Yet, variability continues between specific components of ERAS pathways across and within surgical specialties. Driver elements accounting for the heterogeneous impact of ERAS on perioperative outcomes in gynecologic surgery need to be determined, with most previously assessed protocols not including incisional infiltration with liposomal bupivacaine (LB).

Abdominal and robotic sacrocolpopexy costs following implementation of enhanced recovery after surgery

“…The key distinction is that the present study is the first to consider the impact of ERAS with incisional infiltration of liposomal bupivacaine on open sacrocolpopexy recovery. As we previously reported, ERAS implementation led to a decrease in mean LOS from 2.9 to 1.8 days, and 84.7% of women were discharged within 2 days (37.4% within 23 h; 48.9% by day 1) 23 . In the other studies cited earlier, mean LOS for open groups ranged from 3.0 to 3.3 days; only 1% of women undergoing open sacrocolpopexy were discharged in less than 2 days 4,10 .…”

“…As we previously reported, ERAS implementation led to a decrease in mean LOS from 2.9 to 1.8 days, and 84.7% of women were discharged within 2 days (37.4% within 23 h; 48.9% by day 1). 23 In the other studies cited earlier, mean LOS for open groups ranged from 3.0 to 3.3 days; only 1% of women undergoing open sacrocolpopexy were discharged in less than 2 days. 4,10 Predictably, hospitalization cost savings with the ERAS-associated decrease in LOS led to our novel, distinct finding of significantly higher costs with the robotic procedure.…”