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SAGES

Reimagining surgical care for a healthier world

  • Introduction
  • Preoperative
  • Intraoperative
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    • Frequently Asked Questions (FAQ)
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Surgery Type: Bowel

Mild hypothermia through shivering and vasoconstriction elicits a stress response and increases rates of surgical site infection. Passive and active warmers are used to maintain normothermia (>35.5°). (1) For more information, see Chapter 7: Prevention of Hypothermia in The SAGES / ERAS® Society Manual of Enhanced Recovery Programs for Gastrointestinal Surgery References 1. Forbes SS, […]

Posted on
07/01/2015
Surgery Type
Bowel
Building Blocks
Intraoperative

Enhanced recovery programs depend greatly on the ability to support patients with early nutrition, multimodal analgesia and ambulation, none of which can be achieved unless the GI tract is functioning well. PONV prophylaxis begins in the operative room. Laparoscopic surgery may increase the risk of PONV while adequate hydration and opioid minimization are protective. A […]

Posted on
07/01/2015
Surgery Type
Bowel
Building Blocks
Intraoperative

Urinary catheter: For routine laparoscopic right colectomy, the urinary catheter is removed in the operating room. Even in the presence of a thoracic epidural, urinary catheters can be removed on POD1 in patients at low risk for urinary retention. A bladder scan based protocol is used to monitor for urinary retention in patients who do […]

Posted on
07/01/2015
Surgery Type
Bowel
Building Blocks
Postoperative

There are many key aspects of ERPs under the primary responsibility of the anesthesiology team including attenuation of surgical stress, fluid therapy, analgesia, and maintenance of normothermia and euglycemia. An anesthesia protocol allowing for rapid awakening is used. Deep neuromuscular blockade may help with exposure during laparoscopic surgery at lower pressures of pneumoperitoneum. For more […]

Posted on
07/01/2015
Surgery Type
Bowel
Building Blocks
Intraoperative

Multimodal analgesia: Optimal pain management while avoiding opioids is a key enabler of patient recovery. Furthermore, poor acute pain management is a strong risk factor for the development of chronic pain. A multimodal approach is recommended, using multiple strategies before, during and after surgery. Postoperatively: patients are prescribed routine (not PRN) acetominophen 1gm q6hours and […]

Posted on
07/01/2015
Surgery Type
Bowel
Building Blocks
Postoperative

Nasogastric tubes: Prophylactic NG tubes are not inserted routinely after bowel surgery. Meta-analyses of trials in mainly lower GI surgery found that bowel function was accelerated and pulmonary complications reduced when NGs were not used (1). NG tube insertion postoperatively may be required in up to 15% of patients. After gastrectomy, a meta-analysis comparing routine […]

Posted on
07/01/2015
Surgery Type
Bowel
Building Blocks
Intraoperative

Beginning in the surgeon’s office and continued with the preoperative clinic education, the patient and their family are provided with the daily plan for each day of hospitalization. These include milestones to achieve for diet and activities, information about management of pain and drains and the target discharge day if all goes well. These are […]

Posted on
07/01/2015
Surgery Type
Bowel
Building Blocks
Postoperative

Newer Content

SAGES Enhanced Recovery

SAGES improves quality patient care through education, research, innovation and leadership, principally in gastrointestinal and endoscopic surgery.

Representing a worldwide community of more than 6,000 surgeons, SAGES sets the clinical and educational guidelines on standards of practice in various procedures, critical to enhancing patient safety and health.

SAGES Support

SAGES gratefully acknowledges Medtronic for its generous educational grant in support of the SMART Enhanced Recovery Program.

Preoperative
Intraoperative
Postoperative

SAGES Smart Task Force

  • Liane Feldman, Chair
  • Thomas Aloia, Co-Chair
  • Gina Adrales
  • Rajesh Aggarwal
  • Joselin Anandam
  • Conor Delaney
  • Diana Diesen
  • Justin Dimick
  • Julio Fiore Jr.
  • Gerald Fried
  • Pascal Fuchshuber
  • I. Gorgun
  • Alexis Grucela
  • Matthew Hutter
  • Edmundo Inga-Zapata
  • Rohan Joseph
  • Deborah Keller
  • Anne Lidor
  • David Liska
  • Sumeet Mittal
  • Charles Paget III
  • Michele Riordon
  • Vadim Sherman
  • Andrew Wright
  • Tonia Young-Fadok
  • Yulia Zak

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

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