Peer-Reviewed Publication
J Minim Invasive Gynecol2026September 28, 2026Journal Article
Defining the Critical View of Safety and Safe Steps for Parametrial Transection in Minimally Invasive Hysterectomy: A Delphi Consensus Study.
Takayuki Takahashi1, Risa Takai2, Shin Takenaka3, Hikaru Matsuoka4, Iori Kisu5, Osamu Wada-Hiraike6, Yoichiro Yamamoto7, Miyuki Harada8, Yasushi Hirota8, Wataru Yamagami9
1Biomedical Spatial Science Team, RIKEN Center for Advanced Intelligence Project, Nihonbashi 1-chome Mitsui Bldg., 15F, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan; Department of Obstetrics and Gynecology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; Mathematical Intelligence for Medicine, Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; Department of Artificial Intelligence and Medical Science, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan.
2Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; Statistical Genetics Team, RIKEN Center for Advanced Intelligence Project, Nihonbashi 1-chome Mitsui Bldg., 15F, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan; Department for the Promotion of Medical Device Innovation, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan.
3Statistical Genetics Team, RIKEN Center for Advanced Intelligence Project, Nihonbashi 1-chome Mitsui Bldg., 15F, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan; Department for the Promotion of Medical Device Innovation, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan; Department of Obstetrics and Gynecology, Showa Medical University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan. Electronic address: shin-take@med.showa-u.ac.jp.
4Statistical Genetics Team, RIKEN Center for Advanced Intelligence Project, Nihonbashi 1-chome Mitsui Bldg., 15F, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan.
5Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; Department of Obstetrics and Gynecology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan.
6Department of Obstetrics and Gynecology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.
7Biomedical Spatial Science Team, RIKEN Center for Advanced Intelligence Project, Nihonbashi 1-chome Mitsui Bldg., 15F, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan; Mathematical Intelligence for Medicine, Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; Department of Artificial Intelligence and Medical Science, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan.
8Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
9Department of Obstetrics and Gynecology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
Abstract
OBJECTIVE: To establish expert consensus on Critical View of Safety (CVS) criteria and Safe Steps for parametrial transection during minimally invasive hysterectomy (MIH) to support injury prevention and blood-loss control.
DESIGN: Modified Delphi consensus study.
SETTING: Nationwide online survey conducted in Japan from February through June 2025.
PARTICIPANTS: Thirty-three of 34 invited exper…
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