A modified Delphi method toward multidisciplinary consensus on functional convalescence recommendations after abdominal surgery

Daphne C. R. van Vliet, Eva van der Meij, Esther V. A. Bouwsma, Antonie Vonk Noordegraaf, Baukje van den Heuvel, Wilhelmus J. H. J. Meijerink, W. Marchien van Baal, Judith A. F. Huirne, Johannes R. Anema

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Evidence-based information on the resumption of daily activities following uncomplicated abdominal surgery is scarce and not yet standardized in medical guidelines. As a consequence, convalescence recommendations are generally not provided after surgery, leading to patients' insecurity, needlessly delayed recovery and prolonged sick leave. The aim of this study was to generate consensus-based multidisciplinary convalescence recommendations, including advice on return to work, applicable for both patients and physicians. Using a modified Delphi method among a multidisciplinary panel of 13 experts consisting of surgeons, occupational physicians and general practitioners, detailed recommendations were developed for graded resumption of 34 activities after uncomplicated laparoscopic cholecystectomy, laparoscopic and open appendectomy, laparoscopic and open colectomy and laparoscopic and open inguinal hernia repair. A sample of occupational physicians, general practitioners and surgeons assessed the recommendations on feasibility in daily practice. The response of this group of care providers was discussed with the experts in the final Delphi questionnaire round. Out of initially 56 activities, the expert panel selected 34 relevant activities for which convalescence recommendations were developed. After four Delphi rounds, consensus was reached for all of the 34 activities for all the surgical procedures. A sample of occupational physicians, general practitioners and surgeons regarded the recommendations as feasible in daily practice. Multidisciplinary convalescence recommendations regarding uncomplicated laparoscopic cholecystectomy, appendectomy (laparoscopic, open), colectomy (laparoscopic, open) and inguinal hernia repair (laparoscopic, open) were developed by a modified Delphi procedure. Further research is required to evaluate whether these recommendations are realistic and effective in daily practice
Original languageEnglish
Pages (from-to)5583-5595
JournalSurgical endoscopy
Issue number12
Publication statusPublished - Dec 2016


  • Appendectomy
  • Cholecystectomy
  • Colectomy
  • Convalescence recommendations
  • Hernia repair
  • Modified Delphi study

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