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Updated: Jan 8, 2026
E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Understanding patient and surgeon attitudes towards informed consent for sensitive intraoperative exams in colorectal
Jorge G Zarate Rodriguez1, Catherine N Zivanov2, Jared Yee2
1Division of Colon and Rectal Surgery, Department of Surgery, Mount Sinai Health System, New York, NY, USA.
Background:
There is limited understanding of how consent is obtained for digital rectal (DRE) and intraoperative pelvic exams (IPE) in colorectal surgery.
Methods:
Two-pronged survey of colorectal patients and surgeons. Participants self-rated their agreement with various statements regarding consent for surgery, DRE, and IPE.
Results:
Out of 90 patients, 77 % agreed that surgeons may perform additional procedures other than those explicitly consented to preoperatively. 89 % agreed that DRE was implicit in the consent but 65 % preferred for it to have been explicitly discussed preoperatively. 75 % of patients agreed that IPE was implicit in the consent, but 58 % preferred for it to have been discussed preoperatively. Out 49 surgeons, 74 % routinely perform maneuvers such as IPE or instrumentation of the vagina when performing stapled anastomoses; only 7 % discuss this when obtaining surgical consent.
Conclusions:
Consent discussions should explicitly include sensitive intraoperative exams to prevent erosion of patient autonomy and trust.
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