Power morcellators are medical devices that remove noncancerous growths, typically fibroids, from the uterus. Surgeons use the devices when performing hysterectomies and certain kidney and spleen surgeries. The devices, which are inserted through small incisions and remove tissue after cutting and shredding it, provide a popular alternative to traditional surgery.

Unfortunately, power morcellators also have a risk factor. The devices can put women at increased risk for a number of deadly uterine cancers, including a rare and aggressive type of cancer called leiomyosarcoma.

The FDA issued a safety alert in April 2014, discouraging the use of power morcellators in uterine fibroid removal procedures, as they may spread an undetected or unsuspected uterine sarcoma. In this safety alert, the FDA also noted there is no reliable method for accurately detecting uterine sarcoma prior to hysterectomy surgery.

Why Are Power Morcellators Used?

Gynecologists use power morcellators when they perform procedures such as a hysterectomy. These devices do much of the cutting involved in laparoscopic and robotic surgeries. The morcellators, tiny devices with rotating blades, break large tissue masses into small fragments, which are then vacuumed out of the body.

The technique allows surgeons to remove uterine fibroids and other tissue through incisions of less than 2 centimeters in size. These smaller entry points to the body mean doctors do not have to make large cuts through core stomach muscles. The transition to the small incisions has led to quicker patient recoveries, less post-operative pain and fewer wound complications.

Study Examines Morcellator Cancer Risk

Despite the commercial availability of power morcellators for two decades, accurate estimates regarding the prevalence of cancer at the time of morcellation have been lacking.

Researchers in one study, published in the medical journal JAMA, used a large insurance database to investigate the prevalence of underlying cancer in women who underwent uterine morcellation. The researchers identified 232,882 women who underwent minimally invasive hysterectomies from 2006 to 2012. Morcellation was performed in 36,470 (15.7 percent) of the cases. Among women who underwent morcellation, 99 cases of uterine cancer were identified at the time of the procedure, a prevalence of 27 out of 10,000. Other malignancies and precancerous abnormalities were also detected.

Power Morcellators Pulled From Market

In response to the 2104 FDA communication, Johnson & Johnson’s power morcellator manufacturing unit, Ethicon, suspended all worldwide sales and distribution of power morcellators and ordered a voluntary market withdrawal, affecting all Johnson & Johnson morcellator products. Several hospitals have also suspended use of these devices and multiple insurance carriers will no longer cover procedures involving power morcellation