Development of a surgical competency assessment tool for sentinel lymph node dissection by minimally invasive surgery for endometrial cancer
IntroductionSentinel lymph node dissection is widely used in the staging of endometrial cancer. Variation in surgical techniques potentially impacts diagnostic accuracy and oncologic outcomes, and poses barriers to the comparison of outcomes across institutions or clinical trial sites. Standardizati...
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| Veröffentlicht in: | International journal of gynecological cancer 2021-05, Vol.31 (5), p.647-655 |
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| creator | Moloney, Kristen Janda, Monika Frumovitz, Michael Leitao, Mario Abu-Rustum, Nadeem R Rossi, Emma Nicklin, James L Plante, Marie Lecuru, Fabrice R Buda, Alessandro Mariani, Andrea Leung, Yee Ferguson, Sarah Elizabeth Pareja, Rene Kimmig, Rainer Tong, Pearl Shuang Ye McNally, Orla Chetty, Naven Liu, Kaijiang Jaaback, Ken Lau, Julio Ng, Soon Yau Joseph Falconer, Henrik Persson, Jan Land, Russell Martinelli, Fabio Garrett, Andrea Altman, Alon Pendlebury, Adam Cibula, David Altamirano, Roberto Brennan, Donal Ind, Thomas Edward De Kroon, Cornelis Tse, Ka Yu Hanna, George Obermair, Andreas |
| description | IntroductionSentinel lymph node dissection is widely used in the staging of endometrial cancer. Variation in surgical techniques potentially impacts diagnostic accuracy and oncologic outcomes, and poses barriers to the comparison of outcomes across institutions or clinical trial sites. Standardization of surgical technique and surgical quality assessment tools are critical to the conduct of clinical trials. By identifying mandatory and prohibited steps of sentinel lymph node (SLN) dissection in endometrial cancer, the purpose of this study was to develop and validate a competency assessment tool for use in surgical quality assurance.MethodsA Delphi methodology was applied, included 35 expert gynecological oncology surgeons from 16 countries. Interviews identified key steps and tasks which were rated mandatory, optional, or prohibited using questionnaires. Using the surgical steps for which consensus was achieved, a competency assessment tool was developed and subjected to assessments of validity and reliability.ResultsSeventy percent consensus agreement standardized the specific mandatory, optional, and prohibited steps of SLN dissection for endometrial cancer and informed the development of a competency assessment tool. Consensus agreement identified 21 mandatory and three prohibited steps to complete a SLN dissection. The competency assessment tool was used to rate surgical quality in three preselected videos, demonstrating clear separation in the rating of the skill level displayed with mean skills summary scores differing significantly between the three videos (F score=89.4; P |
| doi_str_mv | 10.1136/ijgc-2020-002315 |
| format | Article |
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Variation in surgical techniques potentially impacts diagnostic accuracy and oncologic outcomes, and poses barriers to the comparison of outcomes across institutions or clinical trial sites. Standardization of surgical technique and surgical quality assessment tools are critical to the conduct of clinical trials. By identifying mandatory and prohibited steps of sentinel lymph node (SLN) dissection in endometrial cancer, the purpose of this study was to develop and validate a competency assessment tool for use in surgical quality assurance.MethodsA Delphi methodology was applied, included 35 expert gynecological oncology surgeons from 16 countries. Interviews identified key steps and tasks which were rated mandatory, optional, or prohibited using questionnaires. Using the surgical steps for which consensus was achieved, a competency assessment tool was developed and subjected to assessments of validity and reliability.ResultsSeventy percent consensus agreement standardized the specific mandatory, optional, and prohibited steps of SLN dissection for endometrial cancer and informed the development of a competency assessment tool. Consensus agreement identified 21 mandatory and three prohibited steps to complete a SLN dissection. The competency assessment tool was used to rate surgical quality in three preselected videos, demonstrating clear separation in the rating of the skill level displayed with mean skills summary scores differing significantly between the three videos (F score=89.4; P<0.001). Internal consistency of the items was high (Cronbach α=0.88).ConclusionSpecific mandatory and prohibited steps of SLN dissection in endometrial cancer have been identified and validated based on consensus among a large number of international experts. A competency assessment tool is now available and can be used for surgeon selection in clinical trials and for ongoing, prospective quality assurance in routine clinical care.</description><identifier>ISSN: 1048-891X</identifier><identifier>EISSN: 1525-1438</identifier><identifier>DOI: 10.1136/ijgc-2020-002315</identifier><identifier>PMID: 33664126</identifier><language>eng</language><publisher>England: by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology</publisher><subject>Adult ; Agreements ; Cancer and Oncology ; Cancer och onkologi ; Clinical Competence ; Clinical Medicine ; Clinical trials ; Competency tests ; Consensus ; Delphi Technique ; Demographics ; Dissection ; Endometrial cancer ; endometrial neoplasms ; Endometrial Neoplasms - surgery ; Female ; Gynecology ; Gynecology - methods ; Humans ; Klinisk medicin ; Lymphatic system ; Male ; Medical and Health Sciences ; Medicin och hälsovetenskap ; Middle Aged ; Minimally invasive surgery ; Minimally Invasive Surgical Procedures - methods ; Oncology ; operative ; Quality control ; Quality standards ; Questionnaires ; sentinel lymph node ; Sentinel Lymph Node Biopsy - methods ; Sentinel Lymph Node Biopsy - standards ; Standardization ; Surgeons ; surgical oncology ; surgical procedures ; Surgical techniques ; Surveys and Questionnaires ; Task analysis ; Uterine cancer ; Validity</subject><ispartof>International journal of gynecological cancer, 2021-05, Vol.31 (5), p.647-655</ispartof><rights>IGCS and ESGO 2021. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology.</rights><rights>2021 IGCS and ESGO 2021. No commercial re-use. See rights and permissions. Published by BMJ.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b6121-8d4cae3a386153758bb6d43675cc254dc6da74ac1fc56aa852f42ab0c881b2ef3</citedby><cites>FETCH-LOGICAL-b6121-8d4cae3a386153758bb6d43675cc254dc6da74ac1fc56aa852f42ab0c881b2ef3</cites><orcidid>0000-0002-4863-1747 ; 0000-0001-5260-199X ; 0000-0001-9689-1298 ; 0000-0002-0810-2648 ; 0000-0002-7093-6862 ; 0000-0003-4427-9421 ; 0000-0003-0093-0438</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,550,776,881</link.rule.ids><linktorsrc>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:149870254$$EView_record_in_Swedish_Publication_Index_(SWEPUB)$$FView_record_in_$$GSwedish_Publication_Index_(SWEPUB)$$Hfree_for_read</linktorsrc><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33664126$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://lup.lub.lu.se/record/6a463414-0060-4f9b-aa55-c60744ac6f2a$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:149870254$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Moloney, Kristen</creatorcontrib><creatorcontrib>Janda, Monika</creatorcontrib><creatorcontrib>Frumovitz, Michael</creatorcontrib><creatorcontrib>Leitao, Mario</creatorcontrib><creatorcontrib>Abu-Rustum, Nadeem R</creatorcontrib><creatorcontrib>Rossi, Emma</creatorcontrib><creatorcontrib>Nicklin, James L</creatorcontrib><creatorcontrib>Plante, Marie</creatorcontrib><creatorcontrib>Lecuru, Fabrice R</creatorcontrib><creatorcontrib>Buda, Alessandro</creatorcontrib><creatorcontrib>Mariani, Andrea</creatorcontrib><creatorcontrib>Leung, Yee</creatorcontrib><creatorcontrib>Ferguson, Sarah Elizabeth</creatorcontrib><creatorcontrib>Pareja, Rene</creatorcontrib><creatorcontrib>Kimmig, Rainer</creatorcontrib><creatorcontrib>Tong, Pearl Shuang Ye</creatorcontrib><creatorcontrib>McNally, Orla</creatorcontrib><creatorcontrib>Chetty, Naven</creatorcontrib><creatorcontrib>Liu, Kaijiang</creatorcontrib><creatorcontrib>Jaaback, Ken</creatorcontrib><creatorcontrib>Lau, Julio</creatorcontrib><creatorcontrib>Ng, Soon Yau Joseph</creatorcontrib><creatorcontrib>Falconer, Henrik</creatorcontrib><creatorcontrib>Persson, Jan</creatorcontrib><creatorcontrib>Land, Russell</creatorcontrib><creatorcontrib>Martinelli, Fabio</creatorcontrib><creatorcontrib>Garrett, Andrea</creatorcontrib><creatorcontrib>Altman, Alon</creatorcontrib><creatorcontrib>Pendlebury, Adam</creatorcontrib><creatorcontrib>Cibula, David</creatorcontrib><creatorcontrib>Altamirano, Roberto</creatorcontrib><creatorcontrib>Brennan, Donal</creatorcontrib><creatorcontrib>Ind, Thomas Edward</creatorcontrib><creatorcontrib>De Kroon, Cornelis</creatorcontrib><creatorcontrib>Tse, Ka Yu</creatorcontrib><creatorcontrib>Hanna, George</creatorcontrib><creatorcontrib>Obermair, Andreas</creatorcontrib><title>Development of a surgical competency assessment tool for sentinel lymph node dissection by minimally invasive surgery for endometrial cancer</title><title>International journal of gynecological cancer</title><addtitle>Int J Gynecol Cancer</addtitle><description>IntroductionSentinel lymph node dissection is widely used in the staging of endometrial cancer. Variation in surgical techniques potentially impacts diagnostic accuracy and oncologic outcomes, and poses barriers to the comparison of outcomes across institutions or clinical trial sites. Standardization of surgical technique and surgical quality assessment tools are critical to the conduct of clinical trials. By identifying mandatory and prohibited steps of sentinel lymph node (SLN) dissection in endometrial cancer, the purpose of this study was to develop and validate a competency assessment tool for use in surgical quality assurance.MethodsA Delphi methodology was applied, included 35 expert gynecological oncology surgeons from 16 countries. Interviews identified key steps and tasks which were rated mandatory, optional, or prohibited using questionnaires. Using the surgical steps for which consensus was achieved, a competency assessment tool was developed and subjected to assessments of validity and reliability.ResultsSeventy percent consensus agreement standardized the specific mandatory, optional, and prohibited steps of SLN dissection for endometrial cancer and informed the development of a competency assessment tool. Consensus agreement identified 21 mandatory and three prohibited steps to complete a SLN dissection. The competency assessment tool was used to rate surgical quality in three preselected videos, demonstrating clear separation in the rating of the skill level displayed with mean skills summary scores differing significantly between the three videos (F score=89.4; P<0.001). Internal consistency of the items was high (Cronbach α=0.88).ConclusionSpecific mandatory and prohibited steps of SLN dissection in endometrial cancer have been identified and validated based on consensus among a large number of international experts. A competency assessment tool is now available and can be used for surgeon selection in clinical trials and for ongoing, prospective quality assurance in routine clinical care.</description><subject>Adult</subject><subject>Agreements</subject><subject>Cancer and Oncology</subject><subject>Cancer och onkologi</subject><subject>Clinical Competence</subject><subject>Clinical Medicine</subject><subject>Clinical trials</subject><subject>Competency tests</subject><subject>Consensus</subject><subject>Delphi Technique</subject><subject>Demographics</subject><subject>Dissection</subject><subject>Endometrial cancer</subject><subject>endometrial neoplasms</subject><subject>Endometrial Neoplasms - surgery</subject><subject>Female</subject><subject>Gynecology</subject><subject>Gynecology - methods</subject><subject>Humans</subject><subject>Klinisk medicin</subject><subject>Lymphatic system</subject><subject>Male</subject><subject>Medical and Health Sciences</subject><subject>Medicin och hälsovetenskap</subject><subject>Middle Aged</subject><subject>Minimally invasive surgery</subject><subject>Minimally Invasive Surgical Procedures - methods</subject><subject>Oncology</subject><subject>operative</subject><subject>Quality control</subject><subject>Quality standards</subject><subject>Questionnaires</subject><subject>sentinel lymph node</subject><subject>Sentinel Lymph Node Biopsy - methods</subject><subject>Sentinel Lymph Node Biopsy - standards</subject><subject>Standardization</subject><subject>Surgeons</subject><subject>surgical oncology</subject><subject>surgical procedures</subject><subject>Surgical techniques</subject><subject>Surveys and Questionnaires</subject><subject>Task analysis</subject><subject>Uterine cancer</subject><subject>Validity</subject><issn>1048-891X</issn><issn>1525-1438</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>D8T</sourceid><recordid>eNqFkluL1DAcxYso7rr67pMEfBGkmnvTF0HWKwz4ouBbSNN_ZzKbNjVpZ5jv4Ic2nRkXVxAfQnM559eTcIriKcGvCGHytduubUkxxSXGlBFxr7gkgoqScKbu5znmqlQ1-X5RPEppizGuKa4fFheMSckJlZfFz3ewAx_GHoYJhQ4ZlOa4dtZ4ZEM_wgSDPSCTEqR01EwheNSFiFJeuQE88od-3KAhtIBal4V2cmFAzQH1bnC98f6A3LAzye3gCId4OAJgaEMPU3TLv8xgIT4uHnTGJ3hy_l4V3z68_3r9qVx9-fj5-u2qbCShpFQttwaYYUoSwSqhmka2nMlKWEsFb61sTcWNJZ0V0hglaMepabBVijQUOnZVlCdu2sM4N3qMOWc86GCcPm_d5BloLpniOOtX_9T7ecyjyWMxSJMtnHCNscSad3WjjRFCW4krniPJjpqMe3PCZVYPrc0PGY2_Q717MriNXoedrrkUCosMeHEGxPBjhjTp3iUL3psBwpw05bXi9ZIkS5__Jd2GOQ75dTUVijEmcq6swieVjSGlCN1tGIL10jS9NE0vTdOnpmXLsz8vcWv4Xa0s4CfBPvgJYrrx8x6i3oDx0yZTchlFVS3tJVjkVblskWx7ebI1_fb_KX4BAmPw4A</recordid><startdate>20210501</startdate><enddate>20210501</enddate><creator>Moloney, 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of a surgical competency assessment tool for sentinel lymph node dissection by minimally invasive surgery for endometrial cancer</title><author>Moloney, Kristen ; Janda, Monika ; Frumovitz, Michael ; Leitao, Mario ; Abu-Rustum, Nadeem R ; Rossi, Emma ; Nicklin, James L ; Plante, Marie ; Lecuru, Fabrice R ; Buda, Alessandro ; Mariani, Andrea ; Leung, Yee ; Ferguson, Sarah Elizabeth ; Pareja, Rene ; Kimmig, Rainer ; Tong, Pearl Shuang Ye ; McNally, Orla ; Chetty, Naven ; Liu, Kaijiang ; Jaaback, Ken ; Lau, Julio ; Ng, Soon Yau Joseph ; Falconer, Henrik ; Persson, Jan ; Land, Russell ; Martinelli, Fabio ; Garrett, Andrea ; Altman, Alon ; Pendlebury, Adam ; Cibula, David ; Altamirano, Roberto ; Brennan, Donal ; Ind, Thomas Edward ; De Kroon, Cornelis ; Tse, Ka Yu ; Hanna, George ; Obermair, Andreas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b6121-8d4cae3a386153758bb6d43675cc254dc6da74ac1fc56aa852f42ab0c881b2ef3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Agreements</topic><topic>Cancer and Oncology</topic><topic>Cancer och onkologi</topic><topic>Clinical Competence</topic><topic>Clinical Medicine</topic><topic>Clinical trials</topic><topic>Competency tests</topic><topic>Consensus</topic><topic>Delphi Technique</topic><topic>Demographics</topic><topic>Dissection</topic><topic>Endometrial cancer</topic><topic>endometrial neoplasms</topic><topic>Endometrial Neoplasms - surgery</topic><topic>Female</topic><topic>Gynecology</topic><topic>Gynecology - methods</topic><topic>Humans</topic><topic>Klinisk medicin</topic><topic>Lymphatic system</topic><topic>Male</topic><topic>Medical and Health Sciences</topic><topic>Medicin och 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Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SwePub</collection><collection>SWEPUB Lunds universitet full text</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SWEPUB Lunds universitet</collection><collection>SwePub Articles full text</collection><jtitle>International journal of gynecological cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>Moloney, Kristen</au><au>Janda, Monika</au><au>Frumovitz, Michael</au><au>Leitao, Mario</au><au>Abu-Rustum, Nadeem R</au><au>Rossi, Emma</au><au>Nicklin, James L</au><au>Plante, Marie</au><au>Lecuru, Fabrice R</au><au>Buda, Alessandro</au><au>Mariani, Andrea</au><au>Leung, Yee</au><au>Ferguson, Sarah Elizabeth</au><au>Pareja, Rene</au><au>Kimmig, Rainer</au><au>Tong, Pearl Shuang Ye</au><au>McNally, Orla</au><au>Chetty, Naven</au><au>Liu, Kaijiang</au><au>Jaaback, Ken</au><au>Lau, Julio</au><au>Ng, Soon Yau Joseph</au><au>Falconer, Henrik</au><au>Persson, Jan</au><au>Land, Russell</au><au>Martinelli, Fabio</au><au>Garrett, Andrea</au><au>Altman, Alon</au><au>Pendlebury, Adam</au><au>Cibula, David</au><au>Altamirano, Roberto</au><au>Brennan, Donal</au><au>Ind, Thomas Edward</au><au>De Kroon, Cornelis</au><au>Tse, Ka Yu</au><au>Hanna, George</au><au>Obermair, Andreas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Development of a surgical competency assessment tool for sentinel lymph node dissection by minimally invasive surgery for endometrial cancer</atitle><jtitle>International journal of gynecological cancer</jtitle><addtitle>Int J Gynecol Cancer</addtitle><date>2021-05-01</date><risdate>2021</risdate><volume>31</volume><issue>5</issue><spage>647</spage><epage>655</epage><pages>647-655</pages><issn>1048-891X</issn><eissn>1525-1438</eissn><abstract>IntroductionSentinel lymph node dissection is widely used in the staging of endometrial cancer. Variation in surgical techniques potentially impacts diagnostic accuracy and oncologic outcomes, and poses barriers to the comparison of outcomes across institutions or clinical trial sites. Standardization of surgical technique and surgical quality assessment tools are critical to the conduct of clinical trials. By identifying mandatory and prohibited steps of sentinel lymph node (SLN) dissection in endometrial cancer, the purpose of this study was to develop and validate a competency assessment tool for use in surgical quality assurance.MethodsA Delphi methodology was applied, included 35 expert gynecological oncology surgeons from 16 countries. Interviews identified key steps and tasks which were rated mandatory, optional, or prohibited using questionnaires. Using the surgical steps for which consensus was achieved, a competency assessment tool was developed and subjected to assessments of validity and reliability.ResultsSeventy percent consensus agreement standardized the specific mandatory, optional, and prohibited steps of SLN dissection for endometrial cancer and informed the development of a competency assessment tool. Consensus agreement identified 21 mandatory and three prohibited steps to complete a SLN dissection. The competency assessment tool was used to rate surgical quality in three preselected videos, demonstrating clear separation in the rating of the skill level displayed with mean skills summary scores differing significantly between the three videos (F score=89.4; P<0.001). Internal consistency of the items was high (Cronbach α=0.88).ConclusionSpecific mandatory and prohibited steps of SLN dissection in endometrial cancer have been identified and validated based on consensus among a large number of international experts. A competency assessment tool is now available and can be used for surgeon selection in clinical trials and for ongoing, prospective quality assurance in routine clinical care.</abstract><cop>England</cop><pub>by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology</pub><pmid>33664126</pmid><doi>10.1136/ijgc-2020-002315</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-4863-1747</orcidid><orcidid>https://orcid.org/0000-0001-5260-199X</orcidid><orcidid>https://orcid.org/0000-0001-9689-1298</orcidid><orcidid>https://orcid.org/0000-0002-0810-2648</orcidid><orcidid>https://orcid.org/0000-0002-7093-6862</orcidid><orcidid>https://orcid.org/0000-0003-4427-9421</orcidid><orcidid>https://orcid.org/0000-0003-0093-0438</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext_linktorsrc |
| identifier | ISSN: 1048-891X |
| ispartof | International journal of gynecological cancer, 2021-05, Vol.31 (5), p.647-655 |
| issn | 1048-891X 1525-1438 |
| language | eng |
| recordid | cdi_swepub_primary_oai_swepub_ki_se_463840 |
| source | SWEPUB Freely available online |
| subjects | Adult Agreements Cancer and Oncology Cancer och onkologi Clinical Competence Clinical Medicine Clinical trials Competency tests Consensus Delphi Technique Demographics Dissection Endometrial cancer endometrial neoplasms Endometrial Neoplasms - surgery Female Gynecology Gynecology - methods Humans Klinisk medicin Lymphatic system Male Medical and Health Sciences Medicin och hälsovetenskap Middle Aged Minimally invasive surgery Minimally Invasive Surgical Procedures - methods Oncology operative Quality control Quality standards Questionnaires sentinel lymph node Sentinel Lymph Node Biopsy - methods Sentinel Lymph Node Biopsy - standards Standardization Surgeons surgical oncology surgical procedures Surgical techniques Surveys and Questionnaires Task analysis Uterine cancer Validity |
| title | Development of a surgical competency assessment tool for sentinel lymph node dissection by minimally invasive surgery for endometrial cancer |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-27T07%3A10%3A42IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_D8T&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Development%20of%20a%20surgical%20competency%20assessment%20tool%20for%20sentinel%20lymph%20node%20dissection%20by%20minimally%20invasive%20surgery%20for%20endometrial%20cancer&rft.jtitle=International%20journal%20of%20gynecological%20cancer&rft.au=Moloney,%20Kristen&rft.date=2021-05-01&rft.volume=31&rft.issue=5&rft.spage=647&rft.epage=655&rft.pages=647-655&rft.issn=1048-891X&rft.eissn=1525-1438&rft_id=info:doi/10.1136/ijgc-2020-002315&rft_dat=%3Cproquest_D8T%3E2583335744%3C/proquest_D8T%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2583335744&rft_id=info:pmid/33664126&rfr_iscdi=true |