Abdominopelvic inspection during nonemergent laparoscopic procedures: who looks?

Abstract

A study was performed to determine whether surgeons and gynecologists inspect the entire abdomen/pelvis at the time of nonemergent laparoscopic surgery. A retrospective chart audit was conducted of patients who underwent elective laparoscopic cholecystectomy or laparoscopic tubal ligation. Dictated and hand-written operative notes were reviewed. Any documentation of the pelvic structures from cholecystectomy operative notes or the upper abdomen from tubal ligation operative notes was determined to be positive for abdominopelvic surveillance. A total of 771 operative notes were reviewed, which included 358 tubal ligations and 413 laparoscopic cholecystectomies. Two hundred four of 358 (57%) tubal ligations performed by gynecologists had a survey of the upper abdomen versus 36 of 413 (8.7%) cholecystectomies performed by surgeons that had a survey of the pelvis. Gynecologists and general surgeons either do not document or do not perform total abdominopelvic inspection universally.