Archives of Gynecology and Obstetrics

, Volume 300, Issue 5, pp 1317–1324 | Cite as

Evaluating the use of Clavien-Dindo classification and Picker Patient Experience Questionnaire as quality indicators in gynecologic endoscopy

  • Sebastian Findeklee
  • Julia Caroline Radosa
  • Stefanie Schafhaupt
  • Shadi Younes
  • Christoph G. Radosa
  • Anke Mothes
  • Erich Franz Solomayer
  • Marc Philipp RadosaEmail author
General Gynecology



Over the last few decades, laparoscopy has become a standard procedure within gynecological surgery. Validated quality indicators for the determination of the objective (perioperative complications) and subjective (patient satisfaction) quality of treatment as a surrogate parameter for the success of the treatment have so far found no regular application in the clinical routine. The purpose of this study was to evaluate the use of the Clavien-Dindo (CD) classification for postoperative complications and the Picker Patient Experience Questionnaire (PPE-15) as tools in the evaluation of endoscopic therapies in clinical routine.


Retrospectively, perioperative complications using the CD classification and patient satisfaction utilizing the PPE-15 were reviewed for a total of 212 consecutive patients at a gynecologic endoscopic referral center (Agaplesion Diakonie Kliniken, Kassel, Germany) in September 2018.


An overall complication rate of 13.21% (28 out of 138 patients) was observed. Five patients (2.36%) had complications grade III and above according to the CD classification system. 138 patients out of 212 chose to answer the PPE-15 (return rate 65.01%). 112 patients (81.16%) reported about problems during their treatment in our hospital in their PPE-15. “Purpose of medicines not explained” was the most mentioned item (28.99%) by patients during their hospital stay.


CD classification and PPE-15 may be helpful instruments to evaluate the quality of care in gynecology. The application of both instruments for the assessment of treatment quality in clinical routine should be further investigated in prospective studies.


Laparoscopy Clavien-Dindo-classification Picker-questionnaire Quality assessment 


Compliance with ethical standards

Conflict of interest

We declare that we have no conflict of interest.

Ethical approval

The study was conducted in concordance to the ethical standards of the institution.

Informed consent

Only retrospective data from patient records were analyzed without any intervention. All patients gave their agreement in analyzing and publishing data anonymously before treatment.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Sebastian Findeklee
    • 1
  • Julia Caroline Radosa
    • 1
  • Stefanie Schafhaupt
    • 2
  • Shadi Younes
    • 2
    • 3
  • Christoph G. Radosa
    • 4
  • Anke Mothes
    • 5
  • Erich Franz Solomayer
    • 1
  • Marc Philipp Radosa
    • 2
    • 3
    Email author
  1. 1.Department for Gynecology, Obstetrics and Reproductive MedicineSaarland University HospitalHomburgGermany
  2. 2.Department for GynecologyAgaplesion Diakonie KlinikenKasselGermany
  3. 3.Department for Gynecology and ObstetricsUniversity Hospital LeipzigLeipzigGermany
  4. 4.Department of RadiologyDresden University HospitalDresdenGermany
  5. 5.Department for Gynecology and ObstetricsSt. Georg Hospital EisenachEisenachGermany

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