Steps to a Quicker Recovery
- Your surgical team will likely follow a specific set of guidelines intended to speed recovery and reduce anxiety. You should ask about “ERAS: Enhanced Recovery After Surgery”
- During the operation surgeons take steps to lower stress on the body and minimize post-op pain
- After surgery patients have less pain, and are able to eat normally and get out of bed faster
Surgery for ovarian cancer can vary in duration, depending on the extent of the cancer and your specific case. "My longest ovarian cancer surgery was 14 hours," says
Dr. Amanda Fader, vice chair of gynecologic surgical operations at Johns Hopkins University in Baltimore, though she adds that the average operation is about six hours long. "During that time I want to focus on the woman and personalize her care, so I'll book the entire day and plan on being there as long as she needs me to get the job done." But whether the surgery takes three hours or much longer, it's still a lot of stress on the body, which is under general anesthesia and vulnerable for most of that time.
To minimize the stress and help women recover faster and better from their surgery, doctors follow guidelines called ERAS: Enhanced Recovery After Surgery. These guidelines outline steps that the medical team can take before, during, and after the surgery to help ensure the best possible outcome.
Read More For instance, steps taken before the operation might include having a patient meet with a surgeon or a nurse to talk about the procedure and how best to prepare. Considerations about the surgery itself might include evaluating whether a minimally-invasive procedure could do the job. “And now we’re directly injecting a lot of incisions with local anesthetics so we can lower narcotic and opioid use to minimal levels, and women recover faster,” says Dr. Fader. And post-operative steps have to do with managing pain and pain medications, encouraging physical activity, and determining how quickly to allow food intake. "We're using a lot of different types of medications to prevent nausea and to improve pain control without doping women up on really heavy doses of narcotics, because we know that opioids and narcotics, not only are they habit-forming, but they can really slow down the gut and cause constipation," explains Dr. Fader. These drugs can make patients feel fuzzy and sleepy, which means they may not get up and walk as much. . . "and that could lead to a blood clot and deconditioning." While doctors are trying to minimize the use of opioids and narcotics, they're still an important part of post-surgical recovery. "But we're using them now with a lot of other adjuvant pain medications to enhance pain control," says Dr. Fader.
And with pain under control, not only can women get up and walk more quickly, which aids recovery, but they will feel more like eating afterwards, too. "And that's really important for restoring nutrients," says Dr. Fader.
A focus on recovery and guidelines such as ERAS mean that women now can expect quicker recoveries than in the past. "We want women to have as little disruption as possible during this very stressful treatment period," says Dr. Fader, saying that the steps surgeons and other parts of the medical team take now "lead to faster recoveries, less stress on the body, getting out of the hospital sooner, sleeping in one's own bed, and getting back to your life quicker."
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Dr. Amanda Nickles Fader is both the Vice Chair of Gynecologic Surgical Operations and the Director of the Center for Rare Gynecologic Cancers at The Johns Hopkins Hospital. Read More
