AORN Enhanced Recovery After Surgery
Center of Excellence in Surgical Safety
What is Enhanced Recovery after Surgery?
Enhanced Recovery After Surgery (ERAS) is a comprehensive, evidence-based approach designed to provide patient-centered, interdisciplinary pathways that help surgical patients achieve early recovery
It uses standardized, team-based protocols to ensure every patient receives consistent, high-quality care -no matter their background.
Get Involved
Start with the AORN Gap Analysis Tool to assess current workflows, policies, and resource needs. This tool is designed to help perioperative teams evaluate their current practices against key Enhanced Recovery After Surgery components across the surgical continuum. This tool supports facilities by identifying existing strengths and areas requiring improvement.
Request an Insufflation CE Today
2 Contact Hours
Nursing and Scrub Tech Staff
Through our partnership with the AORN Center of Excellence in Surgical Safety, we provide support when implementing enhanced recovery practices into real-world workflows -improving outcomes without adding complexity.
CONMED's Role
CONMED supports Enhanced Recovery After Surgery with innovative technology designed to provide stable pneumoperitoneum at lower insufflation pressures10,11 – a new guideline added to the Intraoperative Phase (Section 5) of the latest AORN ERAS Guidelines.
Guidline for the Implementation of Enhanced Recovery After Surgery
Intraoperative Phase
Section 5
Implement measures to support surgeons who perform minimally invasive surgical techniques.12-24 [Recommendation]
The field of surgery has experienced a remarkable revolution thanks to minimally invasive techniques. This has led to numerous advantages for patients, including reduced intraoperative complications, decreased blood loss, improved postoperative pain management, shorter hospital stays, better cosmetic outcomes, and faster recovery to normal functioning. Therefore, it is increasingly recommended to opt for minimally invasive approaches, such as conventional laparoscopy, arthroscopic procedures, and robotic‑assisted procedures using low‑pressure insufflation over traditional (i.e., open) surgical approaches.
1 Buda A, Di Martino G, Borghese M, et al. Low-Pressure Laparoscopy Using the AirSeal System versus Standard Insufflation in Early-Stage Endometrial Cancer: A Multicenter, Retrospective Study (ARIEL Study). Healthcare (Basel).
2 Bucur P, Hofmann M, Menhadji A, et al. Comparison of Pneumoperitoneum Stability Between a Valveless Trocar System and Conventional Insufflation: A Prospective Randomized Trial. Urology. 2016;94:274-280. doi:10.1016/j.urology.2016.04.022
3 Covotta M, Claroni C, Torregiani G, et al. A Prospective, Randomized, Clinical Trial on the Effects of a Valveless Trocar on Respiratory Mechanics During Robotic Radical Cystectomy: A Pilot Study. Anesth Analg. 2017;124(6):1794-1801. doi:10.1213/ANE.0000000000002027.
4 Sroussi J, Elies A, Rigouzzo A, Louvet N, Mezzadri M, Fazel A, Benifla JL. Low pressure gynecological laparoscopy (7mmHg) with AirSeal® System versus a standard insufflation (15mmHg): A pilot study in 60 patients. J Gynecol Obstet Hum Reprod. 2017 Feb;46(2):155-158. doi: 10.1016/j.jogoh.2016.09.003. Epub 2017 Jan 30. PMID: 28403972.
5 Razdan S, Ucpinar B, Okhawere KE, Badani KK. The Role of AirSeal in Robotic Urologic Surgery: A Systematic Review. J Laparoendosc Adv Surg Tech. 2023;33(1). doi:10.1089/lap.2022.0153
6 Abaza R, Martinez O, Ferroni MC, Bsatee A, Gerhard RS. Same Day Discharge after Robotic Radical Prostatectomy. J Urol. 2019;202(5):959-963. doi:10.1097/JU.0000000000000353
7 Ferroni MC, Abaza R. Feasibility of robot-assisted prostatectomy performed at ultra-low pneumoperitoneum pressure of 6 mmHg and comparison of clinical outcomes vs standard pressure of 15 mmHg. BJU Int. 2019 Aug;124(2):308-313. doi: 10.1111/bju.14682. Epub 2019 Feb 7. PMID: 30653808
8 Foley CE, Ryan E, Huang JQ. Less is more: clinical impact of decreasing pneumoperitoneum pressures during robotic surgery. J Robot Surg. 2021;15(2):299-307. doi:10.1007/s11701-020-01104-4
9 Ramshaw B, Vetrano V, Jagadish M, Forman B, Heidel E, Mancini M. Laparoscopic approach for the treatment of chronic groin pain after inguinal hernia repair : Laparoscopic approach for inguinodynia. Surg Endosc. 2017;31(12):5267-5274. doi:10.1007/s00464-017-5600-3
10 Saway JP, McCaul M, Mulekar MS, McMahon DP, Richards WO. Review of Outcomes of Low Verses Standard Pressure Pneumoperitoneum in Laparoscopic Surgery. Am Surg. 2022;88(8):1832-1837. doi:10.1177/00031348221084956
11 Bucur P, Hofmann M, Menhadji A, Abedi G, Okhunov Z, Rinehart J, Landman J. Comparison of Pneumoperitoneum Stability Between a Valveless Trocar System and Conventional Insufflation: A Prospective Randomized Trial. Urology. 2016 Aug;94:274-80. doi: 10.1016/j.urology.2016.04.022. Epub 2016 Apr 27. PMID: 27130263.
12 Gianotti L, Sandini M, Romagnoli S, Carli F, Ljungqvist O. Enhanced recovery programs in gastrointestinal surgery: actions to promote optimal perioperative nutritional and metabolic care. Clin Nutr. 2020;39(7):2014-2024. [VA]
13 Gustafsson UO, Scott MJ, Hubner M, et al. Guidelines for perioperative care in elective colorectal surgery: Enhanced Recovery After Surgery (ERAS) Society
14 Joliat GR, Kobayashi K, Hasegawa K, et al. Guidelines for perioperative care for liver surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations 2022. World J Surg. 2023;47(1):11-34. [IIIA]
15 Klek S, Rymarowicz J, Sobocki J, et al. Recommendations for modern perioperative care for elective surgery: consensus of panel of exerts. Pol Przegl Chir. 2023;95(4):1-5. [VA]
16 Latthe P, Panza J, Marquini GV, et al. AUGS-IUGA joint clinical consensus statement on enhanced recovery after urogynecologic surgery: developed by the Joint Writing Group of the International Urogynecological Association and the American Urogynecologic Society. Individual writing group members are noted in the Acknowledgements section. Urogynecology (Phila). 2022;28(11):716-734. [IIIA]
17 Low DE, Allum W, De Manzoni G, et al. Guidelines for perioperative care in esophagectomy: Enhanced Recovery After Surgery (ERAS) Society recommendations. World J Surg. 2019;43(2):299-330. [IIIA]
18 Cerantola Y, Valerio M, Persson B, et al. Guidelines for perioperative care after radical cystectomy for bladder cancer: Enhanced Recovery After Surgery (ERAS) Society recommendations. Clin Nutr. 2013;32(6):879-887. [IIIA]
19 Ashok A, Niyogi D, Ranganathan P, et al. The enhanced recovery after surgery (ERAS) protocol to promote recovery following esophageal cancer resection. Surg Today. 2020;50(4):323-334. [VA]
20 Kowa CY, Jin Z, Gan TJ. Framework, component, and implementation of enhanced recovery pathways. J Anesth. 2022;36(5):648-660. [VA]
21 Scott MJ, Baldini G, Fearon KCH, et al. Enhanced recovery after surgery (ERAS) for gastrointestinal surgery, part 1: pathophysiological considerations. Acta Anaesthesiol Scand. 2015;59(10):1212-1231. [IIIA]
22 Zaouter C, Damphousse R, Moore A, Stevens LM, Gauthier A, Carrier FM. Elements not graded in the cardiac enhanced recovery after surgery guidelines might improve postoperative outcome: a comprehensive narrative review. J Cardiothorac Vasc Anesth. 2022;36(3):746-765. [VA]
23 Scott MJ, Aggarwal G, Aitken RJ, et al. Consensus guidelines for perioperative care for emergency laparotomy Enhanced Recovery After Surgery (ERAS) Society recommendations part 2— emergency laparotomy: intra- and postoperative care. World J Surg. 2023;47(8):1850-1880. [IIIA]
24 Baxter R, Squiers J, Conner W, et al. Enhanced recovery after surgery: a narrative review of its application in cardiac surgery. Ann Thorac Surg. 2020;109(6):1937-1944. [VA]