{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T14:33:25Z","timestamp":1779114805215,"version":"3.51.4"},"reference-count":110,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Erasmus + Programme of the European Union","award":["2020-1-ES01-KA203-082681"],"award-info":[{"award-number":["2020-1-ES01-KA203-082681"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Obesity remains a major global health burden, with metabolic\u2013bariatric surgery being the most efficient long-term treatment strategy. However, both variability in perioperative care and postoperative complications persist. To address these challenges, the EUropean PErioperative MEdical Networking (EUPEMEN) protocol for bariatric surgery was developed to standardize care and enhance perioperative outcomes across European healthcare settings. Methods: The protocol was formulated through close collaboration among experts from multiple disciplines, involving surgeons, anesthetists, nurses, and nutritionists. Its development included a literature review, expert consensus, and the creation of structured perioperative guidelines covering the preoperative, intraoperative, and postoperative phases. Focus areas include patient education, nutritional optimization, early mobilization, opioid-sparing analgesia, and minimally invasive surgical techniques, supported by educational materials and manuals. Technical activities included the development of detailed multimodal rehabilitation manuals translated into five languages, the creation of an open-access online learning platform, training of future educators through a \u201ctrain the trainer\u201d approach, organization of multiplier promotional events, international collaboration meetings to refine the protocol, and revision and standardization of existing perioperative care guidelines to ensure evidence-based, unified practices across Europe. Results: Implementation of the EUPEMEN protocol aims to reduce postoperative complications, enhance recovery, and decrease hospitalization time. Standardized rehabilitation pathways and access to free educational platforms promote consistent care delivery across diverse healthcare environments. Key strategies include early oral intake, limited use of invasive devices, and comprehensive patient preparation. Conclusions: The EUPEMEN protocol introduces an evidence-based, multidisciplinary framework for optimizing perioperative management in bariatric surgery. While variability in resources and adherence may present potential obstacles, its application holds significant promise for improving perioperative outcomes. Future studies are necessary to assess its long-term impact and adaptability in different healthcare settings.<\/jats:p>","DOI":"10.3390\/jcm15051706","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T13:53:20Z","timestamp":1771941200000},"page":"1706","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A Phase-Based, Multidisciplinary Enhanced Recovery Pathway for Bariatric Procedures: The EUropean PErioperative MEdical Networking (EUPEMEN) Collaborative for Obesity Surgery"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0861-8783","authenticated-orcid":false,"given":"Orestis","family":"Ioannidis","sequence":"first","affiliation":[{"name":"Fourth Department of Surgery, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, General Hospital \u201cGeorge Papanikolaou\u201d, 57010 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5650-7319","authenticated-orcid":false,"given":"Elissavet","family":"Anestiadou","sequence":"additional","affiliation":[{"name":"Fourth Department of Surgery, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, General Hospital \u201cGeorge Papanikolaou\u201d, 57010 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7964-1166","authenticated-orcid":false,"given":"Jose M.","family":"Ramirez","sequence":"additional","affiliation":[{"name":"Institute for Health Research Arag\u00f3n, 50009 Zaragoza, Spain"},{"name":"Department of Surgery, Faculty of Medicine, University of Zaragoza, 50009 Zaragoza, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7039-3717","authenticated-orcid":false,"given":"Nicol\u00f2","family":"Fabbri","sequence":"additional","affiliation":[{"name":"Department of Surgery, Azienda Unit\u00e0 Sanitaria Locale Ferrara\u2014University of Ferrara, 44121 Ferrara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier Mart\u00ednez","family":"Ubieto","sequence":"additional","affiliation":[{"name":"Institute for Health Research Arag\u00f3n, 50009 Zaragoza, Spain"},{"name":"Department of Anesthesia, Resuscitation and Pain Therapy, Miguel Servet University Hospital, 50009 Zaragoza, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0699-5689","authenticated-orcid":false,"given":"Carlo Vittorio","family":"Feo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Azienda Unit\u00e0 Sanitaria Locale Ferrara\u2014University of Ferrara, 44121 Ferrara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7560-551X","authenticated-orcid":false,"given":"Antonio","family":"Pesce","sequence":"additional","affiliation":[{"name":"Department of Surgery, Azienda Unit\u00e0 Sanitaria Locale Ferrara\u2014University of Ferrara, 44121 Ferrara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristyna","family":"Rosetzka","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Second Faculty of Medicine, Charles University and Motol University Hospital, 150 06 Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0157-5175","authenticated-orcid":false,"given":"Antonio","family":"Arroyo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Universidad Miguel Hern\u00e1ndez Elche, Hospital General Universitario Elche, 03203 Elche, Spain"},{"name":"Grupo Espa\u00f1ol de Rehabilitaci\u00f3n Multimodal (GERM), 50009 Zaragoza, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5401-1827","authenticated-orcid":false,"given":"Petr","family":"Koci\u00e1n","sequence":"additional","affiliation":[{"name":"Department of Surgery, Second Faculty of Medicine, Charles University and Motol University Hospital, 150 06 Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0623-9074","authenticated-orcid":false,"given":"Luis","family":"S\u00e1nchez-Guill\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Surgery, Universidad Miguel Hern\u00e1ndez Elche, Hospital General Universitario Elche, 03203 Elche, Spain"},{"name":"Grupo Espa\u00f1ol de Rehabilitaci\u00f3n Multimodal (GERM), 50009 Zaragoza, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9440-8282","authenticated-orcid":false,"given":"Ana Pascual","family":"Bellosta","sequence":"additional","affiliation":[{"name":"Institute for Health Research Arag\u00f3n, 50009 Zaragoza, Spain"},{"name":"Department of Anesthesia, Resuscitation and Pain Therapy, Miguel Servet University Hospital, 50009 Zaragoza, Spain"},{"name":"Grupo Espa\u00f1ol de Rehabilitaci\u00f3n Multimodal (GERM), 50009 Zaragoza, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4415-172X","authenticated-orcid":false,"given":"Adam","family":"Whitley","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Hospital Kralovske Vinohrady, 100 34 Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro Bona","family":"Enguita","sequence":"additional","affiliation":[{"name":"Institute for Health 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