Clinical Application of Morcellation: Provider Perceptions Survey (the CAMPPS Study).

Objective: The goal of this research was to explore physicians' perceptions of uterine morcellation and minimally invasive hysterectomy in the setting of new hospital regulations, comparing gynecologists and internal medicine providers, geographic locations, and levels of training. Design: This was a multicenter cross-sectional study. Materials and Methods: A 17-question, anonymous, electronic survey was administered to resident, fellow, and attending gynecologists, and internal medicine physicians at three institutions. Results: Two hundred and twenty-two gynecologists responded for a response rate of 46%. Most gynecologists believe morcellation is safe and acceptable, and the benefits of minimally invasive surgery outweigh the potential risk of cancer dissemination as a result of morcellation. The majority reported that the incidence of occult leiomyosarcoma is rarer than 1 in 350. Physicians from Boston, MA, responded less favorably toward morcellation than providers in Pittsburgh, PA, and Chapel Hill, NC ( p < 0.001). Trainees were not significantly different from attending gynecologists. One hundred and forty-seven internal medicine physicians responded for a response rate of 40%. Compared to internal medicine providers, significantly more gynecologists believe minimally invasive approaches, as opposed to laparotomy, yield the best overall outcome ( p < 0.001), and the benefits of morcellation outweigh its potential risks ( p < 0.001). Compared to gynecologists, more internal medicine physicians felt morcellation should be banned ( p < 0.001). Conclusions: Most gynecologists highly value morcellation as a means of tissue extraction to facilitate minimally invasive approaches in order to provide the most optimal patient outcomes. Gynecologists' opinions regarding morcellation differ by geographical location but not by level of training. Gynecologists responded more favorably toward minimally invasive hysterectomy and morcellation, compared to internal medicine physicians. (J GYNECOL SURG 33:12) [ABSTRACT FROM AUTHOR]