As the concern of cancer linked with the use of powered morcellator devices continues to rise among the U.S. Food and Drug Administration (FDA) and medical professionals, some medical establishments have come to serious decisions regarding the future of morcellation. For example, Johns Hopkins University has recently announced their decision to discontinue using powered morcellators for certain surgeries in postmenopausal women.

The university stated that it will no longer allow its surgeons to use the devices on women over the age of 50 who are undergoing hysterectomy procedures. John Hopkins’ decision was made based on the numerous women who reported developing uterine cancer after undergoing a morcellator hysterectomy.

Powered morcellators are surgical tools used to cut up tissue into sections so it can be easily removed from the uterus. Morcellation became widely popular soon after the power morcellators’ release due to the precise incisions they make and the short hospital recovery period for hysterectomy and myomectomy patients. Before these devices, surgeons had to meticulously make these delicate incisions over the stomach area of the woman’s uterus and remove the fibroid manually. Powered morcellators eliminate this hassle, and allow for less invasive options for women who need to undergo certain laparoscopic procedures.

The recent update to the university’s guidelines primarily focus on “occult malignancies” where cancer can spread without a known source. In a hospital review led by Dr. Ricci, 424 power morcellator procedures performed in between 2005 and 2014 were analyzed, and two uterine sarcomas in two different patients were discovered. While the findings are relatively low, the risk of cancer spread from an undetected sarcoma is serious and should encourage physicians to use alternative laparoscopic methods to morcellation.

For women who do qualify for powered morcellator surgeries, John Hopkins announced that it will take extra safety precautions to further reduce the chances of uterine sarcoma. For one method, the surgeons will isolate their targeted area with an endoscopy bag to catch particles during the surgery, preventing uterine sarcoma from spreading. Additionally, the university stated that it will require a number of medical tests to determine if a patient is able to undergo the procedure, including case peer-review, endometrial sampling, and image testing. Lastly, women must be warned and fully comprehend the risk of uterine sarcoma before undergoing surgeries using the morcellator.

Overview of Powered Morcellator Complications

John Hopkins representatives explain that in light of the recent legal action surrounding the powered morecellator, they believe it would be best to limit their potential liability. It is also important to note that the teaching hospital also ceased using powered morcellators for women who may be at high risk for uterine cancer. Signs that a woman may be at risk of uterine cancer include: family history, pelvic radiation, BRCA mutations, and if they had used the drug tamoxifen.

John Hopkins’ new protocol was announced several days before the FDA announced similar recommendations that other healthcare facilities now follow. These suggestions were posted on Nov. 24, 2014, along with the agency’s statement that using power morcellators in pre or postmenopausal women could be dangerous due to the risk of dormant uterine sarcoma. As of now, there is medical way to diagnose uterine sarcoma before the sarcoma ruptures during the morcellation procedure, which may make way for the thousands of women who are now contending with uterine cancer to receive safe, effective treatment.

Along with this FDA’s warning, the agency has also recommended that physicians consider all treatment options for women undergoing uterine fibroid procedures, and to choose alternatives to powered morcellators when possible. Several other institutes agree with John Hopkins and the FDA, including the Society of Gynecologic Oncology (SGO), which states that these devices should not be used if a uterine sarcoma is suspected to exist. The SGO also states that these devices should not be used for procedures where the patients is treated for a pre-cancerous condition.

The SGO further states that physicians should provide alternative treatment options to the powered morcellators, in order to prevent the risk of uterine cancer. While these new guidelines may not help women who have already been diagnosed with uterine sarcoma, it will hopefully prevent future incidents from occurring. Women who were injured by these devices are encouraged to take file morcellation cancer lawsuits against powered morcellator manufacturers, for failing in their duty to protect their customers.