What is enhanced recovery?

The introduction of enhanced recovery pathways within elective surgery has gained momentum over recent years since the concept of “enhanced recovery” was first described and promoted by Henrik Kehlet. The technique was originally described as a method for treating patients following colonic surgery with its principles centred on a multimodal rehabilitation program to reduce post-operative pain and accelerate rehabilitation. Whilst the principles of the pathway were originally developed and integrated into colorectal surgical pathways, they have also been utilised in numerous operative procedures such as general, visceral, vascular and thoracic surgery, as well as orthopaedic, urological and gynaecological operations.

At its core an ERP is about improving patient outcomes and speeding up patient recovery following surgery. An ERP focuses on optimising every aspect of a patient’s journey and promoting the patient as an active participant in their recovery process and rehabilitation. Successful pathways are delivered by multi-disciplinary teams and are multimodal in their nature with the aim to optimise every step of a patients’ pathway in order to accelerate postoperative recovery, and reduce complications, adverse events and general morbidity.

There is no formal definition of an ERP within the literature and pathways with the same characteristics as enhanced recovery have been described under various headings that include terms such as “Fast-track”, “Rapid Recovery” and “Accelerated Rehabilitation”