ArticleSurgical endoscopy2026
International expert consensus-driven surgical process model for robot-assisted hysterectomy: Delphi study results.
Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Optimal tissue retrieval in robot-assisted total laparoscopic hysterectomy.Journal of robotic surgery · 2026Article
- Comparative outcomes of robotic, laparoscopic, and open hysterectomy for complex hysterectomy: a retrospective study.Frontiers in surgery · 2025Article
Corrections and comments
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Authors and funding
39 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite the widespread use of robot-assisted total laparoscopic hysterectomy (rTLH), there is still significant variability in how the procedure is performed, leading to inconsistencies in surgical outcomes and challenges in training. While existing curricula focus on technical skills, they lack formal models that capture procedural logic and variability. An expert-validated, standardized SPM is essential for improving reproducibility, enhancing surgical education, and enabling integration with artificial intelligence (AI)-driven systems. We sought to develop the first consensus-based surgical process model (SPM) for standard rTLH SPM (e.g., normal BMI, non-enlarged uterus) using a Delphi methodology involving international experts.
methodsA five-round Delphi study was conducted from November 2023 to October 2024 with 35 expert robotic gynecologic surgeons from 10 countries. Panelists iteratively reviewed, refined, and reached consensus on the phases, steps, and SPM paths of rTLH. Consensus was defined as ≥ 75% agreement on Likert scale responses.
resultsThe final SPM comprises 7 phases and 34 surgical steps, each precisely defined through expert consensus. Seven validated SPM paths were identified, reflecting real-world procedural variability while preserving a common surgical practice centered on uterine pedicle dissection.
conclusionsThis study provides the first internationally validated SPM for rTLH, offering a formal, adaptable representation of the procedure. The model supports improved training and objective performance assessment, and serves as a foundational tool for surgical data science and AI applications in robotic gynecologic surgery.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.