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Statements on Morcellation from Medical Organizations

From the Pre-Op Hysterectomy Articles List

Statements on Morcellation from Medical OrganizationsMorcellation has recently become a topic of interest in the world of gynecology. In response to the growing concern, the FDA released a statement in April 2014 cautioning the use of morcellation and began to work towards a future date for scheduling an FDA hearing on the topic to decide on a complete ban on morcellation.

In response to FDA safety advisory, the medical industry has been publishing statements on the topic, and medical organizations, hospitals, and doctors are awaiting further decisions and research on the topic. This article will gather statements and reports by the medical authorities as they become available.

ACOG (American Congress of Obstetricians and Gynecologists)
Founded in 1951 in Chicago, Illinois, ACOG has over 57,000 members and is the nation's leading group of professionals providing health care for women. Now based in Washington, DC, it is a private, voluntary, nonprofit membership organization.

“Power Morcellation and Occult Malignancy in Gynecologic Surgery”
May 2014

Key points from the ACOG report include:
  • Some hysterectomy and myomectomy patients should still have the option of minimally invasive surgery, including the use of power morcellation.
  • A woman should not receive power morcellation if she has uterine cancer or if she is suspected to have it.
  • If power morcellation is an option for a woman, she should have thorough preoperative evaluation for occult malignancy.
  • Women need to understand the risks and benefits of morcellation and alternative treatments. Doctors should get informed consent from each patient.

ACOG calls for:
  • Researching more reliable preoperative diagnostic tests for uterine malignancies
  • Developing more effective and safer morcellation techniques to reduce the risk of spreading tissue
  • Training surgeons on morcellation techniques, pathological evaluation, and diagnosis of tissue fragments extracted via morcellation, as well as better ways to evaluate clinical indications for morcellation
  • Establishing a national registry on gynecologic power morcellation to fill the gap in data regarding undiagnosed uterine sarcomas

AAGL: “Advancing Minimally Invasive Gynecology Worldwide.”

Originally established as the American Association of Gynecologic Laparoscopists in 1971, the AAGL is now the leading association promoting minimally invasive gynecologic surgery among surgeons worldwide. As the field of minimally invasive gynecologic surgery grew, the membership of the AAGL quickly expanded around the globe and came to encompass more than laparoscopy alone.

“Morcellation During Uterine Tissue Extraction”
May 2014

It is the opinion of the AAGL that all existing methods of tissue extraction have benefits and risks, which must be balanced. At this time, we do not believe there is a single method that can protect all patients; therefore, all current methods of tissue extraction should remain available. We believe that an understanding of the issues reviewed in this document will allow surgeons and hospitals to make the most appropriate, informed choices regarding utilization of tissue extraction in individual patients undergoing uterine surgery.

SGO (Society of Gynecologic Oncology)

The Society of Gynecologic Oncology (SGO) is the premier medical specialty society for healthcare professionals trained in the comprehensive management of gynecologic cancers. As a 501(c)(6) organization, the SGO contributes to the advancement of women’s cancer care by encouraging research, providing education, raising standards of practice, advocating for patients and members, and collaborating with other domestic and international organizations. SGO has more than 1,700 members representing the entire gynecologic oncology team in the United States and abroad. Members include primarily gynecologic oncologists, as well as medical oncologists, pathologists, radiation oncologists, hematologists, surgical oncologists, obstetrician/gynecologists, nurses, physician assistants, social workers, fellows-in-training, residents and other allied healthcare professionals interested in the treatment and care of women’s cancer.

From Medscape: “The Morcellation Controversy: A Timeline”
April 24, 2014

SGO President Barbara A. Goff responds to The Lancet editorial, pointing out that "morcellation allows a procedure that would have needed an exploratory laparotomy to be done via minimally invasive methods." Unlike with open surgery, minimally invasive surgery carries less risk of blood loss, surgical-site infection, and venous thrombosis, and reduces length of stay and postoperative pain, she notes.

According to Dr. Goff, "weighing the risk of these common and sometimes deadly complications to the 0.1-0.25% risk that morcellating a fibroid uterus will result in spread of a leiomyosarcoma should be considered, especially given that these sarcomas have a very poor prognosis even if they are removed intact."


We will continue to update our information as more organizations voice their stance on the matter. You can also learn more about morcellation and uterine sarcoma by reading HysterSister's Morcellation Information page and GYN Cancer articles.

This content was written by staff of HysterSisters.com by non-medical professionals based on discussions, resources and input from other patients for the purpose of patient-to-patient support.

Published: 28 May 2014

05-14-2014 - 08:28 AM


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