Laxatives the day before robotic surgery

Recently I performed a robotic ureteroureterostomy on a 7-month-old girl with a left ectopic ureter. Her left colon was very dilated with mostly gas and some hard stool proximally. The procedure went well but I wished I had given her laxatives the day before.

Laxatives the night before and the day of robotic surgery could be beneficial for:

  1. Reimplants: a dilated rectum can interfere with ureteral dissection distally
  2. Ureteroureterostomies, especially on the left side
  3. Pyeloplasties: colon has to be reflected on the right and could be in the way on the left side too.

Also, intraoperative and postoperative narcotic use could cause constipation, making it a preventative move to do laxatives before surgery.

Side effects from 2 over-the-counter saline enemas are likely to be negligible.

Here is a short video of the UU complicated by the dilated colon:

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