Until recently, power morcellators were an emerging option in hysterectomies or myomectomies, but there are now serious concerns regarding the technology. These devices consist of a long rod with a tiny whirring blade on the end, and a vacuum system placed inside the tube. During surgery, the blade minces up tissue, which is then vacuumed up through the rod. Right up until 2014, experts believed the devices were used in about 10 percent of surgeries, and in theory, they are supposed to offer a safer alternative that allows patients to recover faster.
In the vast majority of cases, these devices are used to remove benign tumors known as fibroids from a uterus. Fibroid development is extremely common, and affects up to 80 percent of women by the time they turn 50. And though the tissue is benign, it can cause bleeding, pain, and an enlarged uterus. If removed completely, they will cause no lingering complications for the patient, but the problem with power morcellators is that they often don’t accomplish this.
In other words, the mincing blade often leaves behind a portion of the tissue that is supposed to be removed. If the tissue is necrotic and spreads to other parts of the body, it can cause a serious infection and illness. Even worse, though, is that fibroids occasionally harbor cancerous cells that are effectively “activated” when released from the surrounding tissue. Known as leiomyosarcoma, this cancer is malignant and aggressive, and is also extremely difficult to detect before performing a hysterectomy or myomectomy. In women harboring an undetected leimyosarcoma, power morcellators can result in a rapid onset of life-threatening cancer. In fact, if the cancer is mistakenly spread with the device, the five-year survivability rate of leimyosarcoma drops from 50 percent to as little as four percent. It is basically a death sentence if used in patients harboring cancer. According to the FDA, about 1 in 350 women have an undetected leimyosarcoma lying in wait, and that there is no reliable way of determining who is harboring one.
In an uncharacteristically firm 2014 safety release, the FDA stated that the devices should not be used in most patients eligible for a hysterectomy or myomectomy. Instead, the FDA recommended alternative, safer methods. Manufacturers responded pretty quickly to the release, particularly Johnson & Johnson, which stopped sales of all of its power morcellators. The FDA is organizing additional advisory meetings to determine the course of future treatment.
Even with the quick commercial response, many lawsuits have been filed against device manufacturers. These lawsuits claim that device manufacturers did not research their products carefully enough, and that treating doctors did not inform patients of possible risks before receiving surgery. In many cases, the patients had no idea they were even at risk of cancer, though several died from the disease within a year of their surgery.
In general, doctors should not be using power morcellators anymore, so patients who have undergone surgery involving the device should consult with their doctor immediately and consider cancer screening.