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Updated: Oct 13, 2025

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A consensus-based core feature set for surgical complexity at laparoscopic hysterectomy.

Mathew Leonardi1, Kristy P Robledo2, Sanne J Gordijn3

  • 1Acute Gynaecology, Early Pregnancy, and Advanced Endosurgery Unit, Nepean Hospital, Penrith, Australia; Sydney Medical School Nepean, The University of Sydney, Sydney, Australia; Department of Obstetrics and Gynecology, McMaster University, Hamilton, Canada.

American Journal of Obstetrics and Gynecology
|November 17, 2021
PubMed
Summary

Standardized methods are needed to assess surgical complexity in laparoscopic hysterectomy. An international Delphi consensus study identified 7 core features for patient, uterine, and pelvic characteristics to improve future research on surgical outcomes.

Keywords:
Delphicomplexitycore featurelaparoscopic hysterectomyoutcomestrial

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Area of Science:

  • Gynecologic Surgery
  • Surgical Complexity Assessment
  • Minimally Invasive Procedures

Background:

  • Standardized methods for characterizing surgical complexity in laparoscopic hysterectomy are lacking.
  • This absence hinders understanding the relationship between patient/surgical features and outcomes.
  • Developing core feature sets is crucial for consistent data collection in future trials.

Purpose of the Study:

  • To develop a standardized core feature set for assessing surgical complexity in laparoscopic hysterectomy.
  • Establish a consensus-driven list of variables for future research.

Main Methods:

  • International Delphi consensus study involving global experts.
  • Comprehensive literature review to identify potential features.
  • Three rounds of online surveys with a priori consensus criteria for feature selection.

Main Results:

  • Consensus reached on 7 core features for laparoscopic hysterectomy complexity.
  • Features categorized into patient, uterine, and nonuterine pelvic domains.
  • Included features: obesity, comorbidities, uterine size/fibroids, endometriosis, ovarian cysts, and adhesions.

Conclusions:

  • A robust, consensus-derived core feature set for laparoscopic hysterectomy complexity has been established.
  • This feature set should be incorporated into future studies assessing surgical outcomes.
  • Enhances comparability and understanding of factors influencing laparoscopic hysterectomy outcomes.