AbstractThe objective of this study is to develop a risk-adjusted real-time quality control system in laparoscopic hys-terectomy with respect to blood loss, operative time and adverse events in order to signal derailing surgical perfor-mance in a timely fashion. Based on prior research, uterus weight, body mass index, number of surgeons, prior abdom-inal surgery, and type of laparoscopic hysterectomy were identified as significant covariates predicting successful sur-gical outcome. Cumulative sum (CUSUM) analysis, a model based on dichotomous input (success or“failure”), was select-ed as a predictive tool for performance analysis. Cutoff values were set at blood loss