title: To Morcellate or Not to Morcellate: A Cross-Sectional Survey Of Gynecologic Surgeons.
abstract: OBJECTIVE
  The inadvertent dissemination of uterine cancer cells with the power morcellator has received much attention in the press and a warning from the U.S. Food and Drug Administration. Many hospitals prohibit the use of the morcellator in gynecologic surgery. We conducted a survey in an attempt to assess gynecologic surgeons' beliefs regarding the intracorporeal power morcellation of fibroids in light of the risk of dissemination of malignancy in patients in whom the presence of cancer is unknown before surgery.
  
  
  METHODS
  We conducted an Internet-based survey of 3505 members of the Society of Laparoendoscopic Surgeons (SLS) to assess demographics, current use of the intracorporeal power morcellator, and whether the recent negative press has affected gynecologic surgeons' use of the morcellator.
  
  
  RESULTS
  Of the 3505 SLS members surveyed, 518 responded (response rate, 14.77%). Three hundred thirteen (61%) of the respondents were not using the intracorporeal power morcellator. Of those, 48% reported the reason was a hospital-wide ban, and an additional 17% reported lack of availability (not in stock). Senior attendings with >20 years of experience used the morcellator more often than junior attendings and fellows (P= .007). Furthermore, the morcellator was used significantly less among those with the belief that morcellation of occult malignancy affects survival (P= .013). Three hundred sixty-one (76%) of the participants currently perform laparotomy in fewer than a quarter of their cases; most those cases are still performed using laparoscopic and robot-assisted techniques.
  
  
  CONCLUSIONS
  The recent negative press suggesting that intracorporeal power morcellation can disseminate occult malignancy and affect survival has decreased the use of the morcellator. Despite the declining use of power morcellation, most practicing gynecologic surgeons have not converted their procedures to laparotomy.
authors.affiliation: Department of Obstetrics and Gynecology, Mt Sinai St Luke's and Roosevelt Hospital, New York, New York, USA.
authors.forename: Farr
authors.initials: F
authors.lastname: Nezhat
authors.affiliation: Department of Obstetrics and Gynecology, Mt Sinai St Luke's and Roosevelt Hospital, New York, New York, USA.
authors.forename: Radu
authors.initials: R
authors.lastname: Apostol
authors.affiliation: Department of Obstetrics and Gynecology, Mt Sinai St Luke's and Roosevelt Hospital, New York, New York, USA.
authors.forename: Alexis D
authors.initials: AD
authors.lastname: Greene
authors.affiliation: Department of Obstetrics and Gynecology, North Shore-Long Island Jewish Health System, Great Neck, New York, USA.
authors.forename: Marjorie L
authors.initials: ML
authors.lastname: Pilkinton
mesh_terms: D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data; D007889:Leiomyoma / Q000601:surgery*; D000069577:Morcellation / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D065287:Robotic Surgical Procedures / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014481:United States; D014594:Uterine Neoplasms / Q000601:surgery*
keywords: Fibroid tumor; Leiomyoma; Morcellator; Power morcellation