A Phase-Based, Multidisciplinary Enhanced Recovery Pathway for Bariatric Procedures: The EUropean PErioperative...

Background/Objectives: Obesity remains a major global health burden, with metabolic-bariatric surgery being the most efficient long-term treatment strategy. However, both variability in perioperative care and postoperative complications persist. To address these challenges, the EUropean PErioperative MEdical Networking (EUPEMEN) protocol for bariatric surgery was developed to standardize care and enhance perioperative outcomes across European healthcare settings. Methods: The protocol was formulated through close collaboration among experts from multiple disciplines, involving surgeons, anesthetists, nurses, and nutritionists. Its development included a literature review, expert consensus, and the creation of structured perioperative guidelines covering the preoperative, intraoperative, and postoperative phases. Focus areas include patient education, nutritional optimization, early mobilization, opioid-sparing analgesia, and minimally invasive surgical techniques, supported by educational materials and manuals. Technical activities included the development of detailed multimodal rehabilitation manuals translated into five languages, the creation of an open-access online learning platform, training of future educators through a "train the trainer" approach, organization of multiplier promotional events, international collaboration meetings to refine the protocol, and revision and standardization of existing perioperative care guidelines to ensure evidence-based, unified practices across Europe. Results: Implementation of the EUPEMEN protocol aims to reduce postoperative complications, enhance recovery, and decrease hospitalization time. Standardized rehabilitation pathways and access to free educational platforms promote consistent care delivery across diverse healthcare environments. Key strategies include early oral intake, limited use of invasive devices, and comprehensive patient preparation. Conclusions: The EUPEMEN protocol introduces an evidence-based, multidisciplinary framework for optimizing perioperative management in bariatric surgery. While variability in resources and adherence may present potential obstacles, its application holds significant promise for improving perioperative outcomes. Future studies are necessary to assess its long-term impact and adaptability in different healthcare settings.