Gynecologic ERAS Preoperative Interventions.

Enhanced recovery after surgery (ERAS) protocols have been widely adopted within gynecologic surgery to optimize perioperative outcomes. This chapter discusses the evidence behind preoperative gynecologic ERAS elements, including preadmission counseling, comorbidity optimization, fasting guidelines, preoperative medications, and prehabilitation. Much of the evidence is extrapolated from colorectal and other surgical populations but has been supported within gynecology. Prehabilitation is the newest element, aimed at improving preoperative functional status through exercise, nutrition, and psychological support, with gynecology-specific evidence emerging to support inclusion within ERAS protocols. Preoperative interventions are the foundation of ERAS bundles, and adherence to these elements should be encouraged.