Mechanical bowel preparation for laparoscopic hysterectomy, is it really necessary?

J Obstet Gynaecol. 2017 Nov;37(8):1032-1035. doi: 10.1080/01443615.2017.1318268. Epub 2017 Jun 26.

Abstract

In this prospective randomised single-blind case-controlled cohort study the aim was to compare the effects of mechanical bowel preparation (MBP) on field of vision and surgical comfort during total laparoscopic hysterectomy procedures. The study group was made of 102 patients that had undergone total laparoscopic hysterectomy (TLH), between July 2012 and June 2014. Statistical comparison was made between the means of durations of operation between the two groups divided by visual indexing (VI). The patients with a VI score of less than 2 and those with VI score of 2 or higher were compared in terms of operation duration in regard to the criteria described above. According to calculations, the p value is .664, therefore, making the result statistically not significant at p ≤ .05. In conclusion it can safely be reported that mechanical bowel preparation before laparoscopic hysterectomy was not found to be necessary in this study group. Impact statement Considering recent publications on the subject, the benefits of mechanical bowel preparation before gynaecologic laparoscopy is still a debateable subject and in that regard what we wish to share is that our study is based on an objective visual indexing tool not used before thus making our results reliable on deciding whether or not patients should receive mechanical bowel preparation prior to laparoscopic surgery for benign reasons.

Keywords: Bowel preparation; advanced laparoscopy; laparoscopic hysterectomy; laparoscopy; surgical comfort; visual indexing.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Body Mass Index
  • Cathartics / administration & dosage*
  • Cohort Studies
  • Feces
  • Female
  • Humans
  • Hysterectomy / methods*
  • Intestines
  • Laparoscopy / methods*
  • Operative Time
  • Phosphates / administration & dosage
  • Preoperative Care / methods*
  • Prospective Studies
  • Single-Blind Method
  • Visual Fields

Substances

  • Cathartics
  • Phosphates
  • sodium phosphate