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Revista de cirugía

versión impresa ISSN 2452-4557versión On-line ISSN 2452-4549


DIAZ S., Rodrigo et al. Midline laparotomy technique consensus using the Delphi method. Rev. cir. [online]. 2019, vol.71, n.4, pp.307-317. ISSN 2452-4557.


Traditionally, the main surgical technique to access the abdominal cavity has been midline incision laparotomy, being postoperative complications a main concern. Proper teaching-learning methods could help improving the success of this procedure.


Establish an expert's consensus throughout the Delphi Methodology regarding the main steps that need to be considered in a midline laparotomy.

Materials and Method:

Literature review was conducted, 37 steps were identified and grouped in 3 sections; preparation of the skin, opening incision, and closure. These steps were evaluated online by surgeons of 7 teaching hospitals in Chile.


Consensus was reached in two rounds, 28 of the 37 steps were identified as important or very important for the procedure.


There is a high level of agreement in steps related to preparation of the skin and opening incision. However, there is not a consensus regarding closure of the peritoneum and fascia in one or more layers, being a case to case decision.


Establishment of 28 standardized steps constitutes a contribution to resident teaching programs and the development of simulation materials as an active learning strategy. Satisfactory learning outcomes have a direct impact in the success of the procedure and a lower rate of complications.

Palabras clave : midline laparotomy; Delphi methodology consensus; surgical education; surgical technique.

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