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Updated: Oct 7, 2026
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Published on: November 10, 2018
The ERAS Era in Bariatric Surgery: A Decade of Transformation
Talha Zargar1, Misbah Jabeen1, Mohsin Aijaz Syed2
1Department of General and Minimal Access Surgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India.
Background:
Enhanced Recovery After Surgery (ERAS) protocols have transformed perioperative care in bariatric surgery over the past decade. This prospective, single-center study evaluates the implementation, evolution, and impact of ERAS protocols across a 10-year period from 2016 to 2025.
Methods:
An observational before-after cohort study using prospectively collected registry data enrolled 250 consecutive patients undergoing laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass. ERAS protocol elements were progressively implemented and refined. Outcomes included length of stay (LOS), 30-day readmission, opioid consumption, complications, and patient satisfaction (unvalidated VAS). The cohort was divided into two 5-year epochs (2016-2020 and 2021-2025).
Results:
Mean LOS decreased by 57%, from 2.8 ± 1.2 days to 1.2 ± 0.6 days (p < 0.001). Same-day discharge increased from 12% to 64% (p < 0.001). ERAS compliance improved from 58% to 89% (p < 0.001). Opioid consumption decreased by 72% (p < 0.001). Major complications decreased from 5 events (4.0%) to 2 events (1.6%) (p = 0.04). Thirty-day readmission rates were 3.2% in Epoch 1 versus 2.4% in Epoch 2 (p = 0.68). Patient satisfaction improved from 7.8 to 9.4 (p < 0.001) (unvalidated VAS).
Conclusion:
ERAS protocol maturation was associated with significant reductions in LOS and opioid consumption, improved recovery, and numerically lower major complications. The study was underpowered for uncommon safety outcomes; therefore, findings support feasibility rather than definitive safety claims.
