The Growth of AAGL

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Dr. Mark Perloe: “I’m Mark Perloe, and we’re here at the American Association of Gynecologic Laparoscopists meeting in Atlanta, Georgia. We are lucky to have with us Jordan Phillips who founded the organization and is presently Chairman of the Board and also involved with the AAGL Foundation and ACG, and Dr. Phillips’ wife - Mary Zo Phillips. Dr. Phillips, back in the early seventies laparoscopy was just getting started and so was this organization. Can you tell us how the organization got started, and what was going on in your mind back then?”

Dr. Jordan Phillips: “I found laparoscopy in 1966, the American father of laparoscopy was Dr. Melvin Cohen of Chicago. I had the opportunity of seeing some of his very early pictures of the panoramic view of a female pelvis. This so intrigued me that I immediately went out and bought the instruments to make this procedure possible and started to do laparoscopy at that time. In 1970, I attended a meeting of FIGO, which is the International Federation of Gynecologists and Obstetricians and attended all of the sessions in endoscopy. Unfortunately, I found these sessions lacking in substance and accuracy. I immediately formed the association in 1971 by finding through a MEDLARS search in the Library of Congress all of the people doing laparoscopy throughout the world. There were only 261 citations in the MEDLARS search, and I sent letters to thirty-three individuals that I found through that search and asked them to join me in forming the association. Of the thirty-three, thirty-one responded positively, I then knew I truly had something of interest. We held our first meeting in 1972, in Las Vegas, not knowing how many people would attend and what the response would be. We filled the entire hotel, and there was a huge amount of interest and the interest continues to this day.”

Dr. Mark Perloe: “What do you see as the greatest accomplishments and achievements of the organization?”

Dr. Jordan Phillips: “AAGL has actually been instrumental in changing the health care of women in the United States and around the world. We’ve introduced laparoscopy to many, many centers all over the country. AAGL does statistical studies of the procedures that we perform to try to find the best technique, the safest technique, the one that is most efficacious that actually operates the way it’s suppose to, and we actually disseminate this information to all of our members.”

Dr. Mark Perloe: “Mary Zo, you’ve been at Jordan’s side at the meetings, and I’ve seen you year after year here. How has your participation been a part of this, and what do you feel about the growth of this organization?”

Mary Zo Phillips: “I don’t know whether Jordan had made the comment, but we are a family. So I take pictures - a photodocument - and then send them to everybody so that makes it closer. We are really tied together, I mean, our family grows and we go from generation to generation. We have a new generation now with new technology but also with people. Every time now the people who are in this generation are bringing their children, some of them are students in the medical universities, and they can see the camaraderie that has bound this association.”

Dr. Mark Perloe: “This organization is truly an international family. Can you speak about some of the trips or adventures that you’ve had, both of you, during the course of the organization’s growth?”

Mary Zo Phillips: “We’ve had many trips, we’ve been to Egypt and ridden on camels. We have been to Rome, and last year we had an international meeting. We had the privilege of having an audience with the Pope.”

Dr. Jordan Phillips: “We’ve been to over one-hundred countries around the world, lecturing, demonstrating, and operating to actually disseminate the information about gynecologic laparoscopy and endoscopic procedures.”

Dr. Mark Perloe: “What advances in the technology have you found most exciting?”

Dr. Jordan Phillips: “The latest and newest advance is the use of the micro instruments. Before we used instruments that were 1-cm and 5-cm, now we have instruments that are 2.2 and 2.7 which are micro instruments which makes the procedure safer by going through a smaller opening.”

Dr. Mark Perloe: “One of my greatest frustrations as an educator is that during a resident’s four year program they’re being pulled into many more directions, and their hands-on exposure to laparoscopy is somewhat limited, and at the end of that four years their capabilities may be limited. Can you speak on what role the organization can play in improving that education - both during residency and perhaps afterwards?”

Dr. Jordan Phillips: “We have put on eight programs for residents where we invite residents throughout the United States, Canada, and Mexico to come to our meeting where we have a group of experts lecturing, demonstrating, and having all of the instruments so that the residents have a chance to see and get to know the latest technology which they many times do not get during their residency training. We also have fellowships and preceptorships. The fellowships last a full year and the preceptorships for a week, two weeks, or a month. A preceptee can visit and watch an experienced surgeon operate all day, come with them to their office, and attend pre-operative visitations and post-operative care.”

Dr. Mark Perloe: “Many patients when they’re choosing a medical practitioner are going to ask - what is your experience, and what are your credentials to perform this kind of surgery? What role has AAGL and you played in addressing this concern that the patients have?”

Dr. Jordan Phillips: “We’ve formed a separate corporation or entity called the ACGE - American Association Accreditation for Gynecologic Endoscopy. This Association approves and certifies competence in gynecologic-endoscopic procedures by examining the experience of individuals. We have about 1,000 doctors that have now gone through the entire examination of ACGE to be certified by ACGE of their competence.”

Dr. Mark Perloe: “I think that’s exciting growth and a very important task that the organization has taken on. Do you see the insurance companies demanding this or asking for this in the future?”

Dr. Jordan Phillips: “Several insurance companies and HMO’s have asked whether the doctors are accredited by the ACGE, and if they are accredited, they actually get an increase in their compensation. The reason the insurance companies do this is they feel that they have a more efficient doctor who in the long run will actually save the insurance company money because of a decreased incidence of problems and complications.”

Dr. Mark Perloe: “What’s in the future for AAGL? What meetings are coming up this next year, and where do we go after Atlanta?”

Dr. Jordan Phillips: “Next year, the AAGL’s large annual International Congress will be in Las Vegas at the Bally’s Hotel. Las Vegas always attracts a very large audience. At this meeting, we had over fifty-four countries represented. The AAGL also puts on a series of regional meetings during the year. We have a lecture series on special topics; we have one in February, in Miami, on alternatives to hysterectomy. The public is so interested in finding other methods of solving their medical problems without resorting to hysterectomy that we will have a special program of experts discussing various methods of saving the uterus so the patient does not have to have a hysterectomy. We will also have a program on anatomy where we actually work on fresh human cadavers to improve a surgeon’s technique by being more knowledgeable of anatomy. We put on a series of programs in Cincinnati where we have a live workshop with live animal models where we perform surgery and have doctors train on live models.”

Dr. Mark Perloe: “Thank you so much Dr. Phillips and Mary Zo. You can learn more about AAGL by following the link to their site where meetings and other information about the organization can be found. Thank you so much.”

Dr. Jordan Phillips: “You’re entirely welcome.”