New Program Helps Patients Recover Faster After Surgery
When Cathy Hughes, vice president of nursing outcomes at Virtua, found out she needed colon surgery to treat severe diverticulitis, she was understandably worried. She was concerned that, given the severity of her symptoms, the surgery would lead to a long recovery. There also was a chance that she could end up with a colostomy—a procedure that allows the damaged part of the colon to heal by rerouting it to a waste-collection bag (called an ostomy) that hangs outside the body.
However, Cathy’s expectations changed after meeting with Virtua colorectal surgeon, Keith Meslin, MD. He offered to monitor her closely for three months to allow her colon to heal before surgery and hopefully avoid the need for a colostomy. Dr. Meslin also explained the minimally invasive, robotic-assisted surgery approach and Virtua’s Enhanced Recovery After Surgery (ERAS) protocols.
“By following ERAS protocols, Virtua has been able to reduce the patient’s length of stay and minimize pain significantly—reducing opioid and narcotic use for colorectal surgery patients by almost 50 percent,” said Dr. Meslin. “Many of our ERAS patients go home two or three days after surgery and take nothing more than Tylenol for pain.”
“As a bedside nurse for many years, I saw how difficult it was for patients to recover from colon surgery,” said Cathy. “But, after speaking with Dr. Meslin, I was optimistic—I completely trusted him.”
How does ERAS work?
ERAS was developed to help colorectal surgery patients recover more quickly. It works by having patients and staff follow specific guidelines BEFORE and AFTER surgery.
Before surgery, Virtua patients meet with their doctors to go over the pre-surgery guidelines, which can include following a special diet, quitting smoking or doing specialized exercises.
After surgery, ERAS guidelines include:
- Starting with a liquid diet the day of surgery and moving to a solid diet soon after surgery.
- Managing pain with non-narcotic medications like Tylenol, Celebrex, and Neurontin.
- Walking the same day of surgery.
Another important ERAS component is having a friend or family member act as your ERAS coach. This person helps motivate and encourage you to stay on track—and even stays with you in a private recovery room after surgery.
“One reason why ERAS protocols work is because we’re changing the patient’s mindset and setting expectations for recovery. Instead of planning to stay in the hospital for a week, Virtua patients go into surgery expecting to be back home and pain free in just a few days,” said Dr. Meslin. “That’s a very motivating goal.”
Additionally, Virtua colorectal surgery patients are cared for in a dedicated unit by staff who are trained in ERAS protocols. This ensures consistency of care and makes it easier and more effective to adhere to the guidelines.
Cathy’s surgery was a success. Dr. Meslin performed a robotic-assisted colon resection to remove the damaged part of her colon, without the need for a colostomy. And, by following ERAS protocols, Cathy was back at home three days after surgery.
“I couldn’t believe it. I was walking the same day of the surgery and I went home needing only Tylenol,” said Cathy. “I thought surgery would be a huge hurdle for me to overcome,” she said. “But, Dr. Meslin and his team made it possible for me to get back to my life and feel better than ever—all faster than I thought possible.”
Game changer for surgery
Dr. Meslin emphasized: “ERAS protocols started in colorectal surgery and, over the last three years, have been used with incredible success to reduce length of stay, pain and narcotic use for patients. Now, Virtua is implementing ERAS in every surgical specialty. It’s a game changer with great benefits for our patients.”
Updated July 16, 2019