A recent study shows morcellator fibroid removal is much less common following an FDA warning about the risk of spreading uterine cancer.

Morcellators are surgical devices used to cut up tissue into smaller pieces before removing it from the body.

Morcellation allows for removal of larger masses of tissue through the smaller incisions used in laparoscopic surgery.

Both patients and doctors sometimes favor laparoscopic surgical techniques because they offer certain benefits like a shorter recovery time and reduced risk of infection.

Morcellators have seen some use over the last few years in gynecological surgery to remove uterine fibroids.

Fibroids are growths that develop in the muscle tissue of the uterus. They’re fairly common: most women develop fibroids at some point in their lives.

Generally, fibroids aren’t symptomatic. But sometimes they can cause symptoms like pain, pressure, frequent urination, or excessive menstrual bleeding.

In cases where these symptoms become problematic, surgical removal of fibroids may be in order.

However, recent research and postmarket reports reveal that in the process of cutting up benign tissue, morcellation creates the risk of also cutting up undetected cancerous tissue, spreading it throughout the abdomen where it can lodge and upstage.

FDA Warns Against Morcellation for Fibroids

The FDA summarized the issue in safety communications issued in April and November 2014.

According to those communications, using power morcellators in fibroid removal surgery creates a risk of spreading and upstaging cancerous tissue that went undetected prior to surgery.

While uterine fibroids themselves are not cancerous, the FDA says that about one out of 350 women who undergo hysterectomy or myomectomy for the treatment of fibroids has a uterine sarcoma that goes undetected prior to surgery. So far, there is no reliable way of detecting these sarcomas prior to surgery.

Because of this risk, the FDA now says power morcellators are contraindicated for all but a few patients undergoing hysterectomy or myomectomy for uterine fibroids.

Specifically, the agency says morcellator fibroid removal should not be performed on women who are peri- or post-menopausal, or who are candidates for en bloc tissue removal.

According to the FDA, alternative treatments are available that don’t carry the same risks as morcellator fibroid removal. These include traditional surgical hysterectomy or myomectomy, laparoscopic surgery that does not use morcellation, high-intensity focused ultrasound, and drug therapy.

Study: Morcellator Fibroid Removal on the Decline

While power morcellators have found application in surgery used to remove uterine fibroids, a recent study shows that morcellator fibroid removal has been on the decline since the FDA issued its warning.

The study was published in the August 2016 issue of the Journal of the American Medical Association.

Researchers found that the use of power morcellators in hysterectomies dropped by almost 80 percent following the FDA’s 2014 warning.

In the first quarter of 2013, prior to the warning’s issue, morcellators were used in about 13.5 percent of hysterectomies. That rate plunged to 2.8 percent by the first quarter of 2015.

The researchers also noted that the overall rate of complications remained unchanged over time.