Key Takeaways
- Co-directors: Dr. Fady Khoury-Collado, MD (gynecologic oncologist) and Dr. Leslie Moroz, MD
- Dr. Khoury-Collado has performed 100+ PAS surgeries
- Actively developing techniques to retain the uterus and remove only the placenta
- Multidisciplinary PAS team established since 2018
- Pioneered transverse (not vertical) incision for PAS surgery
Program Overview
The Columbia / NewYork-Presbyterian PAS Center, located in New York, NY, is a high-volume program dedicated to the diagnosis and management of placenta accreta spectrum disorders. The center brings together a multidisciplinary team that has been formally organized since 2018, drawing on the extensive resources of both Columbia University Irving Medical Center and NewYork-Presbyterian Hospital.
With over 100 PAS surgeries performed by the lead surgeon alone, the program has accumulated significant experience in managing the full spectrum of accreta cases, from focal accreta to percreta with bladder involvement. The center's unique positioning within one of the largest academic medical systems in the country provides patients access to a deep bench of surgical and medical subspecialists.
Fertility Preservation Status
Dr. Khoury-Collado has performed over 100 PAS surgeries and the program now manages approximately 50+ patients per year as of 2023. The approach at Columbia/NYP involves a focal excision and reconstruction technique — surgically removing the invaded portion of the myometrium along with the placenta, then reconstructing the uterus. Dr. Khoury-Collado describes the philosophy as: “We try to prevent the bleeding by not delivering the placenta” — a placental non-separation approach that avoids the massive hemorrhage triggered by attempting to manually remove an adherent placenta.1
Strategy A/C: Conservative Surgical (Focal Excision + Reconstruction) — This is primarily a Strategy A approach (one-step conservative surgery involving resection of invaded myometrium + placenta, then uterine reconstruction), with individualized elements (Strategy C) depending on the extent and location of invasion. Unlike Strategy B centers that leave the placenta in situ to resorb, Columbia/NYP removes the placenta at the time of surgery.3
Surgical Innovation: Transverse Incision for PAS
The Columbia/NYP program has pioneered the use of a transverse (rather than vertical) uterine incision for PAS surgery. Traditional teaching calls for a vertical incision placed above the placenta, but the Columbia team has published data suggesting that a transverse approach may offer advantages in certain PAS cases. This represents a meaningful contribution to PAS surgical technique.3
The development of uterine-preserving approaches at Columbia/NYP represents a promising direction, particularly given Dr. Khoury-Collado's background as a gynecologic oncologist, which brings specialized surgical skills in pelvic dissection and vascular control. Patients interested in fertility preservation should ask specifically about their candidacy for the focal excision and reconstruction technique.
Key Physicians
Fady Khoury-Collado, MD
Co-Director, PAS Center
Dr. Khoury-Collado is a gynecologic oncologist who co-directs the Columbia/NYP PAS Center. He has performed over 100 PAS surgeries and is actively developing techniques to preserve the uterus by removing only the placenta. His oncologic surgical training provides specialized expertise in complex pelvic dissection and vascular management that is directly applicable to PAS cases.1
Leslie Moroz, MD
Co-Director, PAS Center & Director, Mothers Center
Dr. Moroz co-directs the PAS Center and also serves as the Director of the Mothers Center at NewYork-Presbyterian. Her dual role ensures that PAS patients receive comprehensive maternal care coordination spanning prenatal planning through postpartum recovery.2
Practice Details
A distinctive feature of the Columbia/NYP PAS Center is the gynecologic oncology partnership at its core. While most PAS programs are led by maternal-fetal medicine specialists, the co-directorship by a gynecologic oncologist brings a complementary surgical skill set — particularly in radical pelvic surgery, urologic anatomy, and vascular control — that is well suited to complex PAS cases involving deep invasion or bladder involvement.
The program has multi-site capability within the NewYork-Presbyterian hospital system, which is one of the largest and most comprehensive healthcare networks in the New York metropolitan area. This allows for flexibility in surgical planning and access to a wide range of subspecialty services as needed for individual patient cases.
Practical Information
Location
- Institution: Columbia University Irving Medical Center / NewYork-Presbyterian Hospital
- City: New York, NY
- Website: Columbia Doctors — Obstetrics & Gynecology
Referrals
Patients with a suspected or confirmed PAS diagnosis can request a referral to the PAS Center through their obstetrician or maternal-fetal medicine specialist. Contact the Columbia OBGYN department directly for information on scheduling a consultation.
References
- Columbia University Department of Obstetrics & Gynecology. 2023 Annual Report. reports.obgyn.columbia.edu
- NewYork-Presbyterian Newsletter. Management of Placenta Accreta Spectrum. nyp.org
- Khoury-Collado F, et al. Transverse versus vertical uterine incision for placenta accreta spectrum. 2024. PMID: 39566520