Defining the Critical View of Safety and Safe Steps for Parametrial Transection in Minimally Invasive Hysterectomy: A Delphi Consensus Study

This Delphi study established consensus on specific surgical techniques to prevent bladder and ureteral injuries and reduce blood loss during cardinal ligament vessel transection. Key measures—such as maintaining a safe distance from the ureter, confirming the course of the deep uterine vein, and using vessel-sealing devices—achieved high agreement (RoA up to 97%). Most statements were adopted in round two, indicating strong and early expert consensus.