Apr 29, 2014, Kris B. Mamula Reporter- Pittsburgh Business Times
A Harvard University affiliated surgeon sharply criticized a common gynecological surgery done at UPMC and Allegheny Health Network hospitals, calling it a “shameful act of professional negligence.”
Dr. Hooman Noorchashm, a cardiovascular surgeon and lecturer at Harvard Medical School, said that mincing uterine tissue with tiny blades for extraction in a process called power morcellation is “no longer a standard of care in the United States” because of its potential to spread cancer. Allegheny General Hospital’s academic partner, Temple University Hospital in Philadelphia, is among the medical centers that have suspended or restricted use of the procedure.
Noorchashm has mounted a campaign to end use of the procedure after his wife, anesthesiologist Dr. Amy Reed, developed advanced cancer following routine power morcellation for hysterectomy. His campaign resulted in an April 17 warning from the Food and Drug Administration about use of the procedure because of its potential to spread undetected cancer.
In a prepared statement, Dr. W. Allen Hogge, chair of the Department of Obstetrics, Gynecology and Reproductive Sciences at the University of Pittsburgh, said UPMC doctors advise patients of the procedure’s surgical risk, then make sure they “understand and accepts those risks.” But Noorchashm, 41, called UPMC’s informed consent practice “ethically flawed.”
“It does nothing to protect the patient, but protects the hospital from liability,” he said. “That’s not medicine, it’s business.
“The scope of this error is pretty enormous.”
There are some 600,000 hysterectomies performed annually, making it among the most common surgical procedures. The rate of power morcellation is about 10 percent.
Power morcellation exposes women to a 1-in-350 risk of dying from cancer, Noorchashm said. Screening for cancer before the minimally invasive procedure is not always effective.
AHN spokesman Dan Laurent said Tuesday afternoon that the system was planning a "comprehensive review of the procedure." In the meantime, every patient would be evaluated individually for the risks and benefits of power morcellation.
But, AHN gynecologic oncologist Thomas Krivak defended use of the device, saying to stop using the procedure was a “mistake.” The procedure should be done in younger patients where the cancer risk is very low, he said.
“The big question is does it make the cancer worse,” he said. “Intuitively the answer is yes, but it really hasn’t been proven.”
Krivak said he was speaking for himself and not for AHN, but said the procedure could be beneficial.
“It just has to be used in a judicious manner, in appropriate patients,” he said.
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