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Temporal trends in minimally invasive myomectomy before and after the US Food and Drug Administration recommendation against electric morcellation
Author(s) -
Pereira Nigel,
Frankel William C.,
Hutchinson Anne P.,
Patel Hency H.,
Mostisser Cheri,
Elias Rony T.
Publication year - 2017
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12128
Subject(s) - medicine , food and drug administration , invasive surgery , laparoscopy , uterine myomectomy , surgery , leiomyoma , minimally invasive procedures , myoma , uterus , environmental health
Objective To investigate the temporal trends in minimally invasive myomectomy at one reproductive medicine center before and after the US Food and Drug Administration ( FDA ) recommendation against electric morcellation. Methods A retrospective chart review was undertaken of patients undergoing minimally invasive myomectomy between April 1, 2012, and April 30, 2016, at a center in New York. Temporal trends in laparoscopic myomectomy ( LM ), robot‐assisted laparoscopic myomectomy ( RAM ), and laparoscopically assisted myomectomy ( LAM ), and intraoperative and postoperative outcomes before and after the April 2014 recommendation were compared. Results Minimally invasive myomectomy was performed in 73 patients. No difference was noted in the rates of minimally invasive myomectomy 2 years before (35/74 [47.3%]) and after (38/79 [48.1%]) the FDA 's recommendation. The ratio of abdominal to minimally invasive myomectomy remained relatively constant before (68/59=1.15) and during the study period (80/73=1.10). There was a significant decrease in LM and RAM and a corresponding rise in LAM immediately after the recommendation ( P< 0.001). Conclusion The rates of minimally invasive myomectomy before and after the FDA 's recommendation did not differ, indicating that technical modifications to laparoscopic technique can allow surgeons to offer minimally invasive myomectomy to patients with symptomatic leiomyomas.