1668 A National Survey: Evaluating Current Practice and Risk Assessment in Morcellation Amongst Gynecologists in the United Kingdom

Abstract

Study Objective To evaluate current practice and adherence to AAGL and BSGE power morcellation guidelines. Design Multiple-choice questionnaire. Setting United Kingdom. Patients or Participants 157 NHS hospitals offering gynaecological services. Interventions n/a. Measurements and Main Results Power morcellation practice patterns, informed consent processes and outcomes over the last 12 months. We received 136 responses (87% response rate). Power morcellation was performed by a third (59, 37.6%) of all UK hospitals. The median number of gynecologists performing morcellation per organisation was 2 (Q1-Q3: 2-4). A median of 7 morcellators (Q1-Q3: 0-17) were purchased and 7 morcellators (Q1-Q3: 1.25-15.75) used per annum. A median of 10 (Q1-Q3: 2.0-15.0) laparoscopic hysterectomies and 5 (Q1-Q3: 0.5-9.0) myomectomies requiring morcellation were performed per annum. Almost, a third of trust did not perform an endometrial biopsy or MRI. 79.7% (47) of trusts consented for power morcellation and 76%, (46) explained risk of inadvertent leiomyosarcoma.83.3%, (50) had no patient literature and almost half had no audit process 45%, (27). Conclusion Current UK practice does not reflect recommendations from the AAGL or BSGE. Deficiencies were identified in pre-operative evaluation, local governance procedures, and consenting practices regarding use of a power morcellator and risk of occult leiomyosarcoma.