Questionnaire elaboration
Demographic data were collected, which included ID number, address, age,
parity, and educational level. After performing a literature search and
review of surgical approaches to hysterectomy, a three-part instrument
was developed (Supplementary annex 1).
In the first question, patients were asked to rank according to their
preferences from most to least important a total of 12 characteristics
of hysterectomy, being 1 the most important and 12 the least relevant
issue in their opinion. These characteristics were chosen based on the
reviewed literature, and consisted of 6 advantages of laparoscopic over
abdominal hysterectomy (AH), and 6 advantages of abdominal over
laparoscopic hysterectomy (LH), as listed below:
Advantages of laparoscopic over abdominal hysterectomy:
1. Lower complication rates (7)
2. Faster return to daily activities (3)
3. Less postoperative pain (3)
4. Smaller scar area (15)
5. Shorter hospital stay (3)
6. Complete visualization of the abdominal cavity (16)
Advantages of abdominal over laparoscopic hysterectomy:
1. Shorter operative times (3)
2. Most commonly used technique worldwide (1)
3. Most available technique at all levels of care (17)
4. Steeper learning curve for surgeons (18)
5. Lower cost (3)
6. Does not necessarily require general anesthesia (19)
Similarly, the second question of the instrument was designed by listing
10 statements, 5 of which were the advantages of vaginal hysterectomy
(VH) when compared with laparoscopic hysterectomy (LH), and 5 items
stating the advantages of LH over VH as listed below:
Advantages of VH over LH:
1. Lower cost (3)
2. No visible scars (15)
3. Shorter operative time (3)
4. Less training time for surgeons (20)
5. Does not necessarily require general anesthesia (21)
Advantages of LH over VH
1. Less pain (6)
2. Shorter hospital stay (6, 22)
3. Less bleeding (23)
4. Faster return to daily activities
5. Complete visualization of the abdominopelvic cavity (5)
Once again, study participants were asked to rank according to their
preferences from most to least important these 10 statements, being 1
the most important and 10 the least relevant issue in their opinion.
A similar methodology was used for the third question of the survey, in
which the listed items were selected by the authors as being the most
relevant, independently of the surgical technique they represented:
1. Pain
2. Recovery time
3. Safe surgery
4. Cost of procedure
5. Number and size of scars
6. Operative time
7. Duration of surgical training required to safely perform procedure
As above, participants were asked to rank from most to least important
all items, being 1 the most important and 7 the least relevant issue in
their opinion.