Share this article on:

Mechanical Bowel Preparation Before Laparoscopic Hysterectomy: A Randomized Controlled Trial

Siedhoff, Matthew T. MD, MSCR; Clark, Leslie H. MD; Hobbs, Kumari A. MD; Findley, Austin D. MD, MSCR; Moulder, Janelle K. MD; Garrett, Joanne M. PhD

doi: 10.1097/AOG.0000000000000121
Contents: Original Research

OBJECTIVE: To examine the influence of mechanical bowel preparation on surgical field visualization during laparoscopic hysterectomy.

METHODS: The study's primary outcome was the percentage of operations rated “good” or “excellent” in terms of surgical field visualization at the outset of the case by the primary surgeon. Additional measures included assessment of visualization during the case and patient perioperative comfort. The study was powered to detect a 20% absolute difference in the proportion of cases rated as “good” or “excellent.”

RESULTS: Seventy-three patients were assigned to mechanical bowel preparation and 73 to no mechanical bowel preparation. The groups were comparable regarding patient and surgery characteristics. No differences were found for this rating between groups (mechanical bowel preparation, 64 of 73 patients [87.7%], compared with no mechanical bowel preparation, 60 of 73 patients [82.2%], P=.36). Surgeons guessed patient assignment correctly 59% of the time (42 of 71 patients) with mechanical bowel preparation and 55% of the time (41 of 75 patients) with no mechanical bowel preparation.

CONCLUSION: Mechanical bowel preparation is well-tolerated but does not influence surgical field visualization for laparoscopic hysterectomy.

CLINICAL TRIAL REGISTRATION: ClinialTrials.gov, www.clinicaltrials.gov, NCT01576965.

LEVEL OF EVIDENCE: I

Mechanical bowel preparation before laparoscopic hysterectomy is tolerated well by patients but does not offer significant advantages in surgical field visualization.

University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Corresponding author: Matthew T. Siedhoff, MD, MSCR, University of North Carolina at Chapel Hill, Department of Obstetrics & Gynecology, Division of Advanced Laparoscopy & Pelvic Pain, Campus Box 7570, Chapel Hill, NC 27599-7570; e-mail: matthew_siedhoff@med.unc.edu.

Funding was provided by a departmental research fund.

Preliminary data were presented as an abstract at the 42nd Annual AAGL Global Congress on Minimally Invasive Gynecology, November 12, 2013, Washington, DC.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2014 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.