A recent issue of an American medical journal contained more bad news for the manufacturers of power morcellators.

Power morcellators are a type of surgical tool used in a specific type of laparoscopic surgery. In laparoscopic surgery, surgeons use specialized instruments and tiny cameras to perform the bulk of surgeries inside the body.

Since surgeons only need to perform small incisions in laparoscopic surgery, they do not have to cut through nearly as much healthy tissue as they would in a more standard surgery. However, many surgeries, like the hysterectomy and procedures to remove uterine fibroids (a type of benign tumor of the uterus), require surgeons to remove tissue from the body.

The small incisions of laparoscopic surgery complicate this. To get around this problem, surgeons use power morcellators, a specialized cutting tool, to cut tissue before removing it from the body. But various studies have found that power morcellators may carry a risk of spreading cancers cells around the body.

Based on concerns raised by previous studies and regulators, researchers performed a study and published their results in the December issue of the American Journal of Obstetrics and Gynecology. In this study, researchers monitored 941 patients who had uterine surgeries with power morcellators.

Researchers found a small but significant number had uterine cancer either immediately after surgeons used power morcellators to perform hysterectomies or remove uterine fibers. None of the patients had any particular risk factor for uterine cancer prior to the procedures.

It is hypothesized that many women who need hysterectomies or have uterine fibroids may have cancerous cells bound up in these tissues, and the use of power morcellators “liberates” these cells during the procedure and allows them to rapidly spread. Cancer treatments and therapies become more complex and challenging once cancer spreads beyond the initial site.

In general, 2014 was not a good year for the makers of power morcellators. Several studies have found similar observations American Journal of Obstetrics and Gynecology, and government regulators have taken note. In April, the U.S. Food and Drug Administration (FDA) issued a statement discouraging the use of power morcellators for hysterectomies or the removal of uterine fibroids.

In November, the agency followed up with a more strongly-worded statement, based on new evidence. The FDA went as far as to mandate a black box warning for power morcellators, the strongest warning the FDA can issue for a drug or medical device.

In this climate, Ethicon, a subsidy of medical behemoth Johnson & Johnson and the market leaders in producing power morcellators, issued a voluntary recall, taking all of their power morcellators off the market, worldwide.

Power morcellator lawsuits have been filled by patients who developed uterine cancer after having a hysterectomy or related procedures with powered morcellators. These lawsuits allege that the manufacturers of power morcellators were aware — or reasonably should have been aware — of the risk of uterine sarcomas and other uterine cancer that could be exacerbated by the use of power morcellators.

These morcellation lawsuits further allege that in spite of these risks, medical companies continued to make, market and distribute power morcellators, endangering the public.