Recommendations to Prevent Urinary Tract Injuries During Laparoscopic Hysterectomy: A Systematic Delphi Procedure Among Experts

Study objective: To reach consensus among experts in the field of laparoscopic gynaecology in uniform recommendations on the prevention and early detection of urinary tract injuries during laparoscopic hysterectomy (LH). Design: A systematic Delphi consensus procedure (Canadian Task Force Classification III). Setting: A tertiary-care university hospital. Population: International gynecologic experts in the field of LH. Methods: Experts were selected according to standard criteria with regard to surgical experience and research. Twenty of 40 experts were willing to participate. Three questionnaires were sent. Each questionnaire was formulated and based on the answers of the previous one. Results: Fourteen experts completed the third questionnaire. In 40 of 65 proposed recommendations, consensus was achieved. Consensus was achieved with respect to required education, learning curve, equipment, restoration of distorted anatomy and on the application of diagnostic tools in early detection of urinary tract injuries. Conclusion: The Delphi technique is a useful tool to achieve consensus regarding urologic complications in LH. Recommendations may serve as a basis for further research and the development of educational programs. Journal of Minimally Invasive Gynecology (2011) 18, 314-321 (c) 2011 AAGL. All rights reserved.