Enhanced Recovery Program

Institutes & Services > Surgical Institute

The Enhanced Recovery Program (also known as Enhanced Recovery Protocol or ERP) is used in other centers across the United States and around the world. The program:

  • Allows you to take part in your own recovery
  • Increases your comfort
  • Decreases your time in the hospital
  • Prevents dehydration
  • Allows you to start drinking and eating sooner after surgery
  • Lowers body’s reaction to stress
  • Does NOT require you to take laxatives or enemas before surgery

If you do not follow this program, you run the risk of anesthesia cancelling your surgery.

Before Surgery

It is important that you remain active. Take a walk every day. Your diet will change.

5 days before surgery

  • Continue your normal diet.
  • Begin taking Impact® three times daily for five days. Impact is a supplement used to prepare your body for surgery and help your body heal after surgery.
  • You can drink Impact® with your meals or in between meals as snacks. Just make sure you drink three 8-ounce cartons a day. If you have diabetes and are concerned with Impact®
    raising your blood sugar, you may drink 4 ounces of Impact six times a day.
  • Impact® is best served cold and has a vanilla flavor to it. If you prefer, you may add 2 tablespoons of chocolate or strawberry syrup to the Impact. Flavored coffee creamers may also be added if you like. However, Impact does not mix well with powders.

1 to 2 days before surgery

Increase carbohydrates. Carbohydrate suggestions include:

  • Pasta and sauce
  • Rice
  • Cereals (oatmeal, corn flakes, rice crispies, wheaties)
  • Bread
  • Grains
  • Beans, lentils, peas
  • Milk
  • Fruits

8 hours before surgery

  • STOP all solid food intake.
  • Drink 32 ounces (4 cups) of regular Gatorade or Powerade.*
  • You may continue other clear liquids. A clear liquid diet is often used before surgery to make sure your digestive tract is empty. This diet contains any liquid or food that when melted becomes a clear liquid. The following are examples of liquids and foods that qualify as clear:
    • Water
    • Ice
    • Clear soda such as Sprite, 7-up, Sierra Mist, etc. (No colas or root beer)
    • Fruit flavored carbonated beverages
    • Clear fruit juice such as apple, cranberry or grape. (No orange juice, vegetable juice, or any other juice containing fiber)
    • Clear sports drinks such as Gatorade or PowerAde
    • Coffee or tea (no cream or milk added)
    • Fat-free broth

3 hours before surgery

  • Drink another 8 ounces of regular Gatorade or Powerade.*
  • After this, do not drink anymore liquids (no chips of ice, no mints, no gum, no sips of water).

*Patients with diabetes, use low-sugar Gatorade or Powerade. Ask your doctor what other changes you should make in your diet if you are having gastric bypass, gastric sleeve, or lap band surgery. Patients with kidney disease or heart failure, follow your doctor’s advice for liquid intake.

After Surgery

Our goals are that:

  • You will begin walking the day of surgery.
  • You will begin clear liquids the evening of surgery.
  • The day after surgery you will have full liquids (pudding, sorbet, cream soup) including the supplement. It may be possible to begin a soft diet (rice, baked chicken, cooked fruits
    and vegetables).
  • You will be chewing gum to aid in digestion.
  • We will be using new methods of pain control that include intravenous Tylenol, and medicine that decreases tissue swelling before and after surgery.

Remember, if you do not follow this program, you run the risk of anesthesia cancelling your surgery!

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