The 4th World Congress of ERAS®, Lisbon, Portugal, 2016

The 4th ERAS® World Congress was held between 27th-30th April 2016, at the Lisbon Marriot Hotel, Portugal and was arguably the most successful to date. As in previous years, it consisted of the ERAS® Course followed by the Scientific Programme. Throughout the Congress, there were many high class and thought-provoking lectures from experts from around the World including North America, Latin America, Australia and South Africa and Europe.

There were nearly 400 registrations for the Congress, with 2/3 of the delegates attending from European Continent, nearly 15% from North America, but with significant numbers too from Asia (8%), South America (5%), Oceania (3%) and Middle East (2%). On a country by country basis, our hosts Portugal provided the most delegates (58) but closely followed by the UK, US, Sweden and Switzerland. The next countries in order of delegates registered were Spain, Italy, Norway, France and Brazil.

The ERAS® course was again a popular event, with the delegates learning about the relevant physiology underpinning the concepts of ERAS, viewed from many perspectives – surgeon, anaesthesiologist, nurse, manager and of course, the patient. There was a step by step approach to implementation of ERAS process and the evidence behind the many elements of care that make up modern ERAS process, including not only the immediate perioperative steps, but also the importance of preoperative patient education and postoperative audit and quality maintenance.

The Scientific Programme some outstanding individual lectures. Of particular note, the prestigious Henrik Kehlet Lecture was given by Professor Rinaldo Bellomo from The University of Melbourne, Australia on “Postoperative urinary output”, and The ERAS Society Lecture was delivered by Professor Paul Greenhaff, from the University of Nottingham, UK on “Immobilisation and muscle function”. Both lectures were superb insights into fundamental physiology and pathophysiology.

There was a popular parallel session on urology and the Delphi process for implementation of guidelines. There was also a session devoted to entirely to Nursing Practice. In addition, new technology and the measurement of the outcomes to which all in ERAS strive (patients, doctors and other healthcare providers and the healthcare purchaser) was debated. The importance of continual challenges of dogma was examined, as was the management of more complicated situations within ERAS, such as diabetes, the elderly and the emergency patient. It is always interesting to return to original research and have papers presented that changed the practice of the experts, as well as how this research is translated into outcome. It was a sign of the worldwide spread of ERAS that there were sessions on newer speciality areas, such as gynaecology, head and neck, breast reconstruction and liver surgery.

The presentation of new and original work and ideas is always a very exciting and thought-provoking area of the ERAS® Congress. Both the oral and poster presentations were again very popular and remind us that whilst ERAS is well established, there are many areas from which we are still learning and that require detailed study and analysis. There were many excellent presentations, with the prize wining oral presentation won by Professor Tom Wainwright (UK) for his team’s work in knee and hip replacements, entitled “How long before routine next-day discharge for primary hip and knee replacement patients in the United Kingdom”.