Prehabilitation: Optimizing Patient Health Before Surgery to Enhance Recovery and Outcomes

Despite advances in perioperative care, poor surgical outcomes remain common, particularly, among patients with low physiological reserve associated with age, frailty, poor fitness, or malnutrition. Multimodal prehabilitation (Prehab)-a proactive, patient-centred strategy combining preoperative exercise, nutrition, and mental health support-aims to improve physiological reserve before surgery. This narrative review outlines the theoretical foundation for Prehab, highlights evidence supporting its safety and effectiveness, and explores its applicability to obstetric and gynecologic surgical care. Although high-quality data in these populations remain limited, emerging studies, especially in gynecologic oncology, suggest potential benefits including reduced complication rates, improved recovery, and enhanced quality of life. Barriers to widespread adoption include problem blindness, lack of ownership, and limited resources. Scalable implementation strategies are discussed, ranging from in-office recommendations to centralized digital platforms. As ongoing trials further clarify its efficacy, we argue that Prehab can be embraced now as a feasible and patient-empowering approach to surgical preparation. Enhancing physiological reserve before surgery is a vital, underused lever for improving outcomes.