Zintegrowana współpraca fizjoterapeuty i chirurga w laparoskopowych operacjach jamy brzusznej w ramach protokołów ERAS – artykuł przeglądowy

Ewa Strój-Loranc

doi:10.31749/2451-0858-SaS-2026-104

Published: 2026-09-01

Vol. 26 (2026)

Integrated collaboration between physiotherapists and surgeons in laparoscopic abdominal surgery within ERAS protocols: a narrative review

Ewa Strój-Loranc

Section: Health Sciences

https://doi.org/10.31749/2451-0858-SaS-2026-104

Abstract

Laparoscopic abdominal surgery is currently a standard approach in many clinical settings, particularly in colorectal, gynecological, bariatric and general surgery. Although minimally invasive techniques reduce surgical trauma, they do not eliminate postoperative respiratory impairment, pain, temporary reductions in functional activity tolerance, or the risk of delayed functional recovery. These issues are particularly relevant in patients with reduced functional reserve, obesity, respiratory or cardiovascular disease, and other comorbidities. The aim of this paper is to present a model of collaboration between the surgeon and the physiotherapist in laparoscopic abdominal surgery within the framework of Enhanced Recovery After Surgery (ERAS), including preoperative preparation, prehabilitation, early mobilization, stages of hospitalization and continuation of care after discharge.

This paper is a narrative review with elements of a conceptual model. It was based on an analysis of current ERAS guidelines and selected publications concerning postoperative pulmonary complications, prehabilitation, perioperative physiotherapy, patient education and early mobilization after abdominal surgery. The aim was not to systematically evaluate all rehabilitation interventions, but to organize evidence of the greatest practical relevance to collaboration between surgical and physiotherapy teams.

The model proposed in the paper involves the physiotherapist during preoperative preparation, who performs a physiotherapy-specific functional assessment, identifies limitations in mobility and functional activity tolerance relevant to therapy planning, contributes information supporting interdisciplinary consideration of prehabilitation, and plans postoperative activity progression. Postoperatively, the model includes daily coordination of physiotherapy with the therapeutic team, assessment of functional readiness for mobilization and monitoring of tolerance to standing and walking, breathing pattern and cough effectiveness, as well as preparation for safe discharge and further rehabilitation. Selected safety variables are monitored only in connection with physiotherapy interventions and do not replace medical or nursing assessment of the patient’s clinical condition. Particular attention is given to diaphragmatic function, respiratory and movement pattern control, and a methodologically cautious approach to interventions targeting postoperative scar tissue, soft tissues and the abdominal wall.

The analysis indicates that integrated collaboration between surgeons and physiotherapists may provide a useful organizational and clinical framework supporting the implementation of local ERAS-based procedures, improving team communication and promoting a more consistent focus on patients’ functional goals. However, the model should be regarded as a conceptual solution whose full clinical value requires further empirical verification in studies based on comparable protocols.

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Strój-Loranc, Ewa. “Integrated Collaboration Between Physiotherapists and Surgeons in Laparoscopic Abdominal Surgery Within ERAS Protocols: A Narrative Review”. Państwo I Społeczeństwo State and Society, vol. 26, Sept. 2026, p. 104, doi:10.31749/2451-0858-SaS-2026-104.

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Vol. 26 (2026)
Published: 2026-01-01

ISSN: 1643-8299

eISSN: 2451-0858

10.31749/2451-0858-SaS

Publisher

AFM Publishing House of the Andrzej Frycz Modrzewski Krakow University

Licence CC

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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Integrated collaboration between physiotherapists and surgeons in laparoscopic abdominal surgery within ERAS protocols: a narrative review

Abstract

Ewa Strój-Loranc

MSHE Poland