A recent study on morcellation surgery has added to the growing debate about the controversial procedure.

Some 50,000 women annually undergo hysterectomies with the use of a device known as a power morcellator, which shreds uterine tissue so it can be removed through laparoscopic incisions, providing for a less invasive surgery.

However, the power morcellator can leave bits of tissue behind that can continue to grow, whether benign or unexpectedly malignant, spreading the cancer throughout the abdomen.

Medical data has shown that one in 350 women who undergo a robotic hysterectomy or myomectomy (the removal of uterine fibroids) are later diagnosed with uterine sarcoma.

But the morcellator has come under intense scrutiny amid a flood of suspicion that the device’s blades may spread unsuspected cancerous tissue outside the uterus.

The FDA issued a safety advisory discouraging surgeons from using the morcellator, followed by a black box warning label on the device alerting that the use of power morcellators during fibroid surgery may spread cancer and decrease the long-term survival of patients.

Black box warnings are reserved for significant risk of serious or life-threatening adverse effects.

The FDA also advised that the power morcellator should no longer be used for hysterectomies or fibroid removal for the vast majority of women getting these procedures. Morcellators were not banned, as some had asked, but contraindicated for removal of uterine tissue in menopausal and post-menopausal women, and in women who are eligible for surgeries that remove uterine tissue intact through the vagina or mini-laparotor.

In the most recent “decision-tree analysis” reported by MedPage Today, women who underwent laparoscopic hysterectomies with the power morcellator for presumed fibroid tumors – compared with women who had abdominal hysterectomies – had fewer overall deaths, fewer surgical complications, and an increased quality of life.

However, more women died from leiomyosarcoma (malignant smooth muscle tumor) after laparoscopic hysterectomy, according research at the University of North Carolina School of Medicine.

Overall, vaginal hysterectomy results in fewer complications and better outcomes for patients and is the preferred route of hysterectomy when possible, Georgetown University Hospital Dr. Hal Lawrence, executive vice president and CEO of the American College of Obstetricians and Gynecologists, told MedPage Today.

Lawrence told MedPage that since not all women are candidates for vaginal hysterectomy, laparoscopic hysterectomy with morcellation and total abdominal hysterectomy should continue to be treatment options.

Class action lawsuit lawyers are looking for women diagnosed with leiomyosarcoma (LMS), uterine sarcoma or other cancer within two years after their initial surgery to remove fibroids, the uterus, ovaries or fallopian tubes.