Women who undergo hysterectomies should question morcellation safety before opting for such a procedure.

A power morcellator is a medical device that chops and grinds tissue during laparoscopic surgery.

The small chunks of tissue can be vacuumed out through small cuts in the abdomen rather than through larger incisions used in traditional surgery.

While originally power morcellators were thought safe for fibroid removal, studies show complications arise because the device scatters pieces of tissue throughout the abdominal cavity.

These tiny pieces of tissue can seed new fibroid growth where they land.

Surprisingly, even benign tissue can be a problem if it grows around the intestines, squeezing them to the point of obstruction. In other cases, previously undetected cancer cells attach to organs where new tumors grow.

Study Examines Morcellation Safety

In a recent cohort study, researchers looked at the medical record data of women who had undergone a hysterectomy over an eight-year period in an effort to determine morcellation safety. Some surgeries included no morcellation, some included a power morcellator and others a non-powered morcellator.

Researchers compared disease-free and overall survival rates at three years among the three methods.

Of 34,603 hysterectomies performed for the primary diagnosis of uterine fibroids:

• 8 percent of the procedures were abdominal, 44.7 percent laparoscopic and 9.5 percent vaginal;
• 293 cancerous fibroids were identified among those who had a hysterectomy;
• 7 percent of the cancers were not suspected prior to hysterectomy;
• Two thirds of the women with cancer were over the age of 50 years;

Researchers determined that the risk of early recurrence is higher and the opportunity for early survival is lower among women who had either power or nonpower morcellation used in their surgeries.

While determining morcellation safety, the study also determined that cancerous uterine fibroids are most often found in women over the age of 50.

Another study also confirmed that morcellation spreads cancer, and went further by recommending better preoperative screening be done. Lab tests and MRIs or CT scans might help identify malignancies in advance of the hysterectomy.

When older patients are diagnosed with fibroids that have quickly developed, researchers said morcellation should not be considered.

Morcellator Safety Concerns Result in Recalls

Johnson & Johnson sold three of the top-selling brands of power morcellators used in gynecological surgeries. Johnson & Johnson stopped sales of its power morcellators in April 2014 and took them off the market in July 2014.

The FDA became so concerned about morcellation safety that the agency warned against using laparoscopic power morcellators in women receiving hysterectomies or uterine fibroid removal.

The FDA estimated that approximately 1 in 350 women undergoing such surgery would be found to have an unsuspected case of uterine cancer.

Symptoms of Advanced Cancer

Women who did not even know they had cancer, but have it advance due to power morcellation, can find themselves diagnosed with Stage IV cancer very quickly.

Symptoms of upstaged cancer after power morcellation:

• Vaginal discharge
• Vaginal bleeding between periods or after menopause
• Pelvic or abdominal pain, swelling, or a mass
• Weight loss
• Nausea or vomiting
• Back pain or nerve issues