Background

There are no current standardized and accepted methods to characterize the surgical complexity of a laparoscopic hysterectomy. This leads to challenges when trying to understand the relationship between the patient and the surgical features and outcomes. The development of core feature sets for laparoscopic hysterectomy studies would enable future trials to measure the similar meaningful variables that can contribute to surgical complexity and outcomes.

Objective

The purpose of this study was to develop a core feature set for the surgical complexity of a laparoscopic hysterectomy.

Study Design

This was an international Delphi consensus study. A comprehensive literature review was conducted to identify the features that were reported in studies on laparoscopic hysterectomy complexity. All the features were presented for evaluation and prioritization to key experts in 3 rounds of online surveys. A priori consensus criteria were used to reach agreement on the final outcomes for inclusion in the core feature set.

Results

Experts represented North America, South America, Europe, Africa, Asia, and Oceania. Most of them had fellowship training in minimally invasive gynecologic surgery. Sixty-four potential features were entered into round 1. Experts reached a consensus on 7 features to be included in the core feature set. These features were grouped under the following domains: 1) patient features, 2) uterine features, and 3) nonuterine pelvic features. The patient features include obesity and other nonobesity comorbidities that alter or limit the ability of a surgeon to perform the basic or routine steps in a laparoscopic hysterectomy. The uterine features include the size and presence of fibroids. The nonuterine pelvic features include endometriosis, ovarian cysts, and adhesions (bladder-to-uterus, rectouterine pouch, and other adhesions).

Conclusion

Using robust consensus science methods, an international consortium of experts has developed a core feature set that should be assessed and reported in all future studies that aim to assess the relationship between the patient features and surgical outcomes of laparoscopic hysterectomy.

中文翻译：

---

腹腔镜子宫切除术手术复杂性的基于共识的核心特征集

背景

目前没有标准化和公认的方法来描述腹腔镜子宫切除术的手术复杂性。当试图了解患者与手术特征和结果之间的关系时，这会带来挑战。腹腔镜子宫切除术研究的核心特征集的开发将使未来的试验能够测量可能有助于手术复杂性和结果的类似有意义的变量。

客观的

本研究的目的是为腹腔镜子宫切除术的手术复杂性开发一套核心特征。

学习规划

这是一项国际德尔福共识研究。进行了全面的文献回顾，以确定腹腔镜子宫切除术复杂性研究中报告的特征。在 3 轮在线调查中，所有功能都提交给关键专家进行评估和优先排序。先验共识标准用于就最终结果达成一致，以纳入核心特征集。

结果

专家代表北美、南美、欧洲、非洲、亚洲和大洋洲。他们中的大多数人接受过微创妇科手术的进修培训。64 个潜在特征进入第一轮。专家们就将 7 个特征纳入核心特征集达成共识。这些特征分为以下几个领域：1) 患者特征，2) 子宫特征，和 3) 非子宫盆腔特征。患者特征包括肥胖和其他非肥胖合并症，这些合并症会改变或限制外科医生在腹腔镜子宫切除术中执行基本或常规步骤的能力。子宫特征包括肌瘤的大小和存在。非子宫盆腔特征包括子宫内膜异位症、卵巢囊肿和粘连（膀胱与子宫、直肠子宫袋和其他粘连）。

结论

使用强大的共识科学方法，一个国际专家联盟开发了一个核心特征集，应在所有未来的研究中评估和报告，旨在评估患者特征与腹腔镜子宫切除术的手术结果之间的关系。