Primary: Assess differences in pre-operative preparedness for patients undergoing in-office compared to virtual and video pre-operative counseling the time of laparoscopic hysterectomy.

Secondary: Examine differences in (1) unplanned clinic or emergency department (ED) visits and (2) readmission rates within a 6-week post-operative period among the two groups.

Design:

Single-center parallel design randomized controlled trial.

Setting:

Multi-specialty academic medical center in the United States.

Patients or Participants:

Patients 20 years and older who underwent a laparoscopic hysterectomy with the Department of Gynecologic Surgical Specialties for benign indications between 6/2021-2/2024.

Interventions:

Patients were randomized to either an in-office or a virtual pre-operative counseling visit. The virtual group also received a link to an informational video to be viewed before their encounter. All participants received a 10-question survey to assess their preparedness for laparoscopic hysterectomy on the day of surgery.

Measurements and Main Results:

Of the 136 patients who consented to participate in the study, 114 patients received the survey intervention (59 in-office and 55 virtual). There was no statistically significant difference between in-office and virtual counseling preparedness scores based on the survey intervention with both groups reporting median scores corresponding to positive responses. Total scores for the survey were similar with 58.0(54.0,60.0) for in-office counseling and 58.0(55.0,60.0) for virtual counseling (p=0.9885). The number of unplanned clinic visits, visits to the Emergency Department (ED) and readmissions were the same for both groups 0.0(0.0,0.0) with p=0.1951, 0.5218, and 0.6091, respectively. Fischer exact and Wilcoxon rank sum tests were performed as applicable.

Conclusion:

There is no difference in patient preparedness for surgery, unplanned clinic or ED visits, or readmissions among the two study groups. This underscores the viability of virtual pre-operative counseling visits in the post-pandemic era and will facilitate access to minimally invasive gynecologic surgery.