Do We Need Mechanical Bowel Preparation before Benign Gynecologic Laparoscopic Surgeries A Randomized, Single-Blind, Controlled Trial

Abstract

Aims: The primary objective of this study was to compare the effect of mechanical bowel preparation (MBP) with oral sodium phosphate (NaP) solution vs. MBP with NaP enema vs. fasting only with respect to intraoperative visualization of the surgical field, ease of bowel handling, and overall ease of surgery in patients undergoing benign gynecologic laparoscopic procedures. Methods: The patients were randomized into one of 3 groups: oral NaP, NaP enema, or fasting only. The primary surgeon and assistant(s) remained blinded to the randomization assignments. Intraoperative visualization of the surgical field, ease of bowel handling, and overall ease of surgery were assessed using a surgeon questionnaire based on Visual Analog Scales. Results: We enrolled 293 women, of whom 278 were randomized to receive oral NaP solution (n = 96), undergo NaP enema (n = 92), or perform fasting only (n = 90). No significant differences were found between the 3 groups. Conclusions: No differences were observed among patients who underwent MBP with oral NaP or NaP enema and those without MBP, with respect to intraoperative visualization of the surgical field, ease of bowel handling, and overall ease of surgery. No benefit of MBP was found when removing large uteri or when operating on patients with a high body mass index.