title: Recommendations to prevent urinary tract injuries during laparoscopic hysterectomy: a systematic Delphi procedure among experts.
abstract: 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).
  
  
  METHODS
  A systematic Delphi consensus procedure (Canadian Task Force Classification III).
  
  
  METHODS
  A tertiary-care university hospital.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Gynaecology, VU University Medical Center, Amsterdam, The Netherlands. pfjanssen@hetnet.nl
authors.forename: P F
authors.initials: PF
authors.lastname: Janssen
authors.forename: H A M
authors.initials: HA
authors.lastname: Brölmann
authors.forename: J A F
authors.initials: JA
authors.lastname: Huirne
mesh_terms: D003697:Delphi Technique; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000193:education; D007431:Intraoperative Complications / Q000175:diagnosis / Q000517:prevention & control*; D010535:Laparoscopy / Q000009:adverse effects* / Q000193:education / Q000379:methods; D059032:Learning Curve; D017410:Practice Guidelines as Topic; D014551:Urinary Tract / Q000293:injuries*