title: Impact of the 2014 Food and Drug Administration Warnings Against Power Morcellation.
abstract: To determine whether members of the AAGL Advancing Minimally Invasive Gynecologic Surgery Worldwide (AAGL) and members of the American College of Obstetricians and Gynecologists Collaborative Ambulatory Research Network (ACOG CARN) have changed their clinical practice based on the 2014 Food and Drug Administration (FDA) warnings against power morcellation.
  
  
  
  A survey study.
  
  
  
  Participants were invited to complete this online survey (Canadian Task Force classification II-2).
  
  
  
  AAGL and ACOG CARN members.
  
  
  
  An online anonymous survey with 24 questions regarding demographics and changes to clinical practice during minimally invasive myomectomies and hysterectomies based on the 2014 FDA warnings against power morcellation.
  
  
  
  A total of 615 AAGL members and 54 ACOG CARN members responded (response rates of 8.2% and 60%, respectively). Before the FDA warnings, 85.8% and 86.9%, respectively, were using power morcellation during myomectomies and hysterectomies. After the FDA warnings, 71.1% and 75.8% of respondents reported stopping the use of power morcellation during myomectomies and hysterectomies. The most common reasons cited for discontinuing the use of power morcellation or using it less often were hospital mandate (45.6%), the concern for legal consequences (16.1%), and the April 2014 FDA warning (13.9%). Nearly half of the respondents (45.6%) reported an increase in their rate of laparotomy. Most (80.3%) believed that the 2014 FDA warnings have not led to an improvement in patient outcomes and have led to harming patients (55.1%).
  
  
  
  AAGL and ACOG CARN respondents reported decreased use of power morcellation during minimally invasive gynecologic surgery after the 2014 FDA warnings, the most common reason cited being hospital mandate. Rates of laparotomy have increased. Most members surveyed believe that the FDA warnings have not improved patient outcomes.
authors.affiliation: Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California. Electronic address: lumd@stanford.edu.
authors.forename: Deirdre A
authors.initials: DA
authors.lastname: Lum
authors.affiliation: Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California.
authors.forename: Eric R
authors.initials: ER
authors.lastname: Sokol
authors.affiliation: Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California.
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Berek
authors.affiliation: American College of Obstetricians and Gynecologists, Washington, DC.
authors.forename: Jay
authors.initials: J
authors.lastname: Schulkin
authors.affiliation: Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY.
authors.forename: Ling
authors.initials: L
authors.lastname: Chen
authors.affiliation: American College of Obstetricians and Gynecologists, Washington, DC.
authors.forename: Cora-Ann
authors.initials: CA
authors.lastname: McElwain
authors.affiliation: Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY.
authors.forename: Jason D
authors.initials: JD
authors.lastname: Wright
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods*; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D000069577:Morcellation / Q000009:adverse effects*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012955:Societies, Medical / Q000706:statistics & numerical data; D014481:United States; D014486:United States Food and Drug Administration; D063186:Uterine Myomectomy / Q000009:adverse effects / Q000379:methods*; D014594:Uterine Neoplasms / Q000601:surgery*
keywords: American Association of Gynecologic Laparoscopists; American College of Obstetricians and Gynecologists; Food and Drug Administration warning; Power morcellation; Survey