Identification of essential steps in laser procedure for twin–twin transfusion syndrome using the Delphi methodology: SILICONE study

• DOI: 10.1002/uog.14761
• Publication Date: 2014-12-11T12:46:15Z
• Authors: S. H. P. Peeters; J. Akkermans; M. Westra; E. Lopriore; J. M. Middeldorp; F. J. Klumper; L. Lewi; R. Devlieger; J. Deprest; E. V. Kontopoulos; R. Quintero; R. H. Chmait; J. S. Smoleniec; L. Otaño; D. Oepkes
• Keywords: Delphi Method

To determine, by expert consensus, the essential substeps of fetoscopic laser surgery (FLS) for twin-twin transfusion syndrome (TTTS) that could be used to create an authority-based curriculum training in this procedure among fetal medicine specialists.A Delphi survey was conducted international panel experts (n = 98) FLS. Experts rated FLS on a five-point Likert-type scale indicate whether they considered them essential, and were able comment each substep, using dedicated online platform accessed invited tertiary care facilities specialize therapy. Responses returned until consensus reached (Cronbach's α ≥ 0.80). All 4 80% included evaluation instrument.After first iteration procedure, response rate 74% (73/98) reached, second third iterations rates 90% (66/73) 81% (59/73) respectively. Among total 81 round, 21 had re-rated round. Finally, from initial list substeps, 55 agreed essential. In 18 categorized ranked order importance, with 'coagulation all anastomoses cross equator' 'determination fetoscope insertion site' as most important.A TTTS defined procedure. This is evidence development final model future surgeons.