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Enhanced Recovery Programme

Enhanced recovery is a way in which we care for our patients before, during and after an operation. There is strong evidence that this will enable you to recover faster from your operation, with fewer complications. This will mean you can go home and return to normal function sooner.

This section of our website provides you with information about what is involved in the enhanced recovery programme. You will also be given a diary that has been designed so that you know what to expect and can plan your recovery on the ward following your operation. This is also available on the website here (HYPERLINK).

The programme involves all the staff caring for you (anaesthetists, nurses, dieticians, physiotherapists and surgeons) helping you to follow a clearly defined programme. Most importantly, it requires your active participation to make it work. It is therefore really important that you have a good idea what to expect and that you understand that the majority of patients can follow the program. It may be hard work, but with help you can meet the targets, and by doing so you will make sure that you get over the operation quicker.

The program is split into different phases before, during and after the operation itself. This aims to make sure that:

  • You are in the best possible condition for surgery;
  • Your operation and anaesthetic are performed to help you recover more quickly afterwards;
  • You have the best post-operative rehabilitation to minimise your risk of problems.

Before the operation

It is really important that you do everything you can to get yourself in the best possible condition for major surgery. This includes:

  • Stopping smoking;
  • Carefully managing your weight;
  • Carefully managing other conditions such as diabetes.

One of the most common problems our patients encounter after surgery is having a chest infection. Sometimes this can be severe, and at times it may be life-threatening. Stopping smoking will make a big difference to help reduce your risk of having a bad chest infection after your operation. The surgical team or your GP can help you obtain support doing this, such as nicotine replacement patches or support groups.

Although many of our patients have difficulty eating and drinking, a lot of people having surgery remain overweight or obese. It is important to have a balanced diet that contains all the nutrition required to ensure you are healthy for your operation. However, if you are overweight, it is also very important to carefully manage your diet and exercise to lose weight in a controlled way. Like being a smoker, being overweight or obese increases the risk of having a bad chest infection after your operation, makes the operation more difficult, and increases the risk of other problems that can occur such as wound infections. Your team can help support and advise you how to achieve controlled weight loss, and can refer you to a dietitian if this is needed.

During the operation

Your team of surgeons and anaesthetists will do their best to perform your operation in a way that allows you to recover as quickly and smoothly as possible.  For example, we routinely use keyhole surgery to reduce pain, although this is not always possible or appropriate for all patients.

After the operation

During your stay after your surgery, you will have goals to achieve each day. For example, this will tell you what you should be drinking and/or eating, and how much you should be moving about and getting out of bed. Detailed information is provided in your diary. For example, on the first day after having an oesophagectomy, you will walk 30 metres or march 30 steps stood on the spot twice. You will also sit out of the bed for two hours twice. Knowing what to expect and what is normal during your recovery will help you achieve these goals, improving your recovery, and reducing your chance of having problems or complications.