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ERAS Approach vs. Keyhole Approach

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Both keyhole and ERAS are two different approaches taken up in surgery. Continue reading to learn about both methods in detail.

Medically reviewed by

Dr. Pandian. P

Published At December 27, 2022
Reviewed AtFebruary 3, 2023

What Is Enhanced Recovery After Surgery?

Enhanced recovery after surgery is an approach that is based on evidence that will help people recover quickly after having major surgery. This enhanced approach after surgery is available in most hospitals and is seen as a standard procedure after surgery after many procedures. Enhanced recovery is also sometimes referred to as rapid or accelerated recovery.

The aim of the ERAS are:

  • To ensure that the patients are healthy before receiving the treatment.

  • Patients should receive the best possible treatment.

  • Patients should receive the best possible care during recovery.

Surgery can be overwhelming for the patient, both physically as well as mentally. An enhanced recovery program will help to get back to a healthy state as early as possible. Studies have shown that after surgery, a patient who starts to walk, eat and drink on their own is sooner to recover after the surgery.

Who Can Benefit From The Enhanced Recovery Program?

The principles of enhanced recovery can be applied to all surgeries. But in some cases, a specifically designed pattern will benefit the patients more than the enhanced recovery.

The types of surgeries and procedures that use enhanced recovery include

  • Breast Surgeries - Like breast removal surgeries in breast cancer cases.

  • Colorectal - Removal of part or all the intestines as a part of treatment for bowel cancer.

  • Gynecology - Surgical removal of the womb.

  • Musculoskeletal - Hip replacement or knee replacement surgeries.

  • Nephrology - Removal of the prostate gland because of prostate cancer.

Even some hospitals advise enhanced recovery even after chest or heart surgery.

What to Look for When Opting for Surgery?

When surgery is advised by the doctor, always ask whether enhanced recovery is followed for the condition suffering in that hospital. To enhance recovery, it is important to play the active role of taking care of self in order for a faster recovery.

Important points that should be considered before the operation include

  • Exercise - Being physically active even before the surgery will aid in faster recovery.

  • Eating Well - Eating healthy food is important as the biopsy will need all the nutrients in adequate amounts during the recovery period for repair.

  • Relax - Try to relax and not worry about the surgery.

  • Avoid Smoking and Alcohol - One should cut down or stop smoking and consuming alcohol as they delay recovery.

The doctor will advise the patient to get into a proper physical state before going for surgery. Also, they will check for other conditions prior to the surgery which can affect the operation or the recovery following the surgery and will be treated adequately before the surgery. The doctor will explain the procedure and all the complications associated with it during the counseling session. They will also explain other available treatment options so that one must be informed about all the treatment options.

What Is Keyhole Surgery?

Keyhole surgery, also known as laparoscopic surgery or minimally invasive surgery, is a type of surgery in which the doctor will be able to access the inside of the abdomen as well as the pelvis without making a larger incision. The surgeons use an instrument called a laparoscope to avoid the large incision that is generally needed in conventional surgical methods. The laparoscopy is a small tube with a light and camera through which the surgeon will be able to see the image on the screen while performing the surgery.

What Are the Advantages of Keyhole Surgery Over Conventional Surgery?

The advantages of keyhole surgery over traditional surgery are as follows:

  • Lesser time of admission in the hospital.

  • Faster recovery.

  • A small wound on the outside.

  • Lesser bleeding after the surgery.

  • Lesser pain.

  • Smaller scar.

When Is Laparoscopy Done?

Laparoscopy can be done to diagnose various conditions on the inside of the abdomen and the pelvis. It can also be done as a surgical procedure for removing a tissue sample and diseased or damaged organs.

Laparoscopy is mostly used for the following:

  • Gynecology - To study and diagnose conditions affecting the female reproductive system.

  • Gastroenterology - To diagnose or be a part of treatment in conditions related to the digestive system.

  • Nephrology - To diagnose or be a part of treatment for conditions related to the urinary system.

How Is Laparoscopy Done?

Laparoscopic procedures are done under general anesthesia. As it is done under general anesthesia, the patient will not feel any pain or any sensations during the procedure.

During the laparoscopy, the surgeon will make one to two incisions in the abdomen. The surgeon will then introduce the laparoscopy through this incision into the abdominal cavity. Along with the laparoscope, other surgical tools as well as a tube to pump gas, are introduced into the abdomen. This will make it easier for the surgeon to do the procedure. Once the procedure is done, the gas gets out of the abdomen, the incision is sutured, and a dressing is applied. The patient will be made to stay in the hospital overnight and will be discharged the following day.

What Are the Complications of Laparoscopy?

Laparoscopic procedures are commonly done, and associated complications are rarely seen.

Minor Complications:

Minor complications may be seen in one or two patients out of a hundred patients in whom laparoscopy is done, and they include:

  • Infections.

  • Minor bleeding around the incision.

  • Vomiting.

  • Feeling sick.

Major Complications:

The major or serious complications after laparoscopy are seen in one patient out of thousand patients, and they are:

  • Damage to the organ, like the bowel or bladder, can result in the loss of organ functioning.

  • Injury to a major artery.

  • Gas bubbles may enter the veins or arteries from the carbon dioxide used during the procedure.

  • Allergic reaction to general anesthesia.

  • A blood clot develops in the vein, especially in the leg, which might break and block the blood flow in any of the lung vessels causing pulmonary embolism.

Conclusion

Enhanced recovery after surgery (ERAS) is a method that is adopted by hospitals for the faster recovery of patients after the surgery, whereas laparoscopy is a surgical procedure that is used for diagnosis as well as treatment purposes. The laparoscopic procedures are much more comfortable for the patients and will help in faster recovery compared to the conventional surgical options. So, both ERAS and laparoscopy aim to make the treatment and recovery phase much easier and faster for the patients.

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Dr. Pandian. P
Dr. Pandian. P

General Surgery

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