Multidisciplinary convalescence recommendations after gynaecological surgery: a modified Delphi method among experts


Prof JR Anema, VU University Medical Center, Department of Public and Occupational Health, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands. Email


Please cite this paper as: Vonk Noordegraaf A, Huirne J, Brölmann H, van Mechelen W, Anema J. Multidisciplinary convalescence recommendations after gynaecological surgery: a modified Delphi method among experts. BJOG 2011;118:1557–1567.

Objective  To generate structured detailed uniform convalescence recommendations after gynaecological surgery by a modified Delphi method amongst experts and a representative group of physicians.

Design  Modified Delphi study.

Setting  Expert physicians recruited by their respective medical boards and employed at different hospitals, doctor’s surgeries and healthcare services.

Population  Twelve experts (five gynaecologists, two general practitioners [GPs] and five occupational physicians [OPs]) and a representative sample of 63 medical doctors.

Methods  Multidisciplinary detailed recommendations for graded resumption of relevant activities after uncomplicated hysterectomy (laparoscopic supracervical, total laparoscopic/laparoscopic-assisted, vaginal and abdominal hysterectomies) and laparoscopic adnexal surgery were developed. Recommendations were based on a literature review and a modified Delphi procedure among 12 experts, recruited in collaboration with the participating medical boards of gynaecologists, GPs and OPs.

Main outcome measures  A multidisciplinary consensus of at least 67% on the relevant detailed convalescence recommendations in relation to hysterectomy and laparoscopic adnexal surgery.

Results  Out of initially 65 activities, the expert panel judged 38 activities relevant for convalescence recommendations. Consensus for all activities was achieved after four Delphi rounds and two group discussions. The recommendations were judged as feasible by a representative sample of 26 gynaecologists, 19 GPs and 18 OPs.

Conclusions  Consensus between gynaecologists, GPs and OPs was achieved on all relevant convalescence recommendations regarding hysterectomy (abdominal, vaginal and laparoscopic) and laparoscopic adnexal surgery.