A recent study published in a national gynecological medicine journal is calling for stronger guidelines against the use of power morcellators in gynecological surgery.

Power morcellators are a type of surgical tool used in laparoscopic surgery. In laparoscopic surgery, surgeons perform the bulk of a surgery inside a patient’s body, using specialized tools. This allows surgeons to make smaller incisions into the body, and cut through less healthy tissue to do their work.

This process is proven to shorten healing time and makes surgery an option for many patients that would normally be high-risk for the complications of regular surgeries. However, for laparoscopic surgeries like a hysterectomy or myomectomy, surgeries to remove uterine fibroids, surgeons need to remove tissue larger than the small incisions used in laparoscopic surgery. Power morcellators are surgical tools designed to help cut tissue into smaller pieces for easy removal. However, concerns have emerged that power morcellators may carry special risks, such as increased risk of cancer because of the spread of cancerous cells by the morcellators.

Concerns have arisen that the process of power morcellation may help spread cancer. Power morcellators are often used in surgeries to remove uterine fibroids, a type of benign tumor of the uterus. However, by U.S. Food and Drug Administration (FDA) estimates, as many as one in 300 uterine fibroids may also carry hidden cancer cells bound up within them. In a regular hysterectomy, these cells would be cleanly removed. But in a laparoscopic hysterectomy, the act of cutting up the uterus with miniaturized power tools may spread cancer cells around the abdomen. How widespread cancer cells are within the body is a major factor determining how serious the cancer is. Many patients who have had a laparoscopic hysterectomy have later been diagnosed with leiomyosarcoma, a type of uterine cancer.

Morcellation Cancer Research Study Raises Concerns

A new research study on power morcellators was published in February 2015 issue of American Journal of Obstetrics & Gynecology (ACOG), a peer-reviewed research journal. In this study, researchers performed a meta-analysis, a type of research wherein researchers pool and compare data from other previous papers. In this case, researchers suggested that more intensive preoperative evaluations could identify women who are at-risk for leiomyosarcoma, and other uterine cancers associated with power morcellator use. However, this advice is at odds with a growing medical consensus that power morcellators should never be used when performing a hysterectomy.

In fact, the FDA issued a warning based on their own data that power morcellators should never be used in a hysterectomy, myomectomy, and related laparoscopic surgeries due to the risk of leiomyosarcoma and other uterine cancers. This series of warnings ultimately included a black box warning on power morcellators from the FDA. In the same timeframe, Johnson & Johnson, the market leader in power morcellators, decided to stop manufacturing the surgical tools.