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Power Morcellator

A power morcellator is a surgical instrument which is used to divide uterine tissue or fibroid tissue so it can be more easily extracted. Studies suggest, however, using the power morcellator may increase the risk of spreading cancerous tissue in patients with undiagnosed uterine cancer, including leiomyosarcoma, endometrial stromal sarcoma, carcinosarcoma, and endometrial adenocarcinoma.

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How are Power Morcellators used?

A power morcellator can be used in several different types of surgeries, including hysterectomies, the removal of uterine fibroids (myomectomy), and the treatment of uterine fibroids. The morcellator is used to divide or morcellate the tissue into parts or fragments that can more easily be removed during the surgery through small incision points.

Power morcellators have allowed doctors to remove uterine leiomyomata, also known as fibroids, in women. Women who suffer from fibroids can often experience a variety of issues such as pelvic pain, infertility, and heavy uterine bleeding.

By using the morecellators, doctors have been able to perform what they consider “minimally invasive gynecologic surgery (MIGS).” Now doctors are able to remove large fibroids through small incisions, which allows for faster healing and recovery, less pain, lower risk of infection, faster return to daily activities, and a smaller incision site.

Uterine sarcoma can spread with power morecellation

Recent reports by the FDA indicate that power morcellation may cause issues for women who have uterine sarcoma. According to the FDA, 1 in 350 women who decide to have a hysterectomy or myomectomy for the treatment of fibroids may have uterine sarcoma. Using power morcellation for the removal of the fibroids may increase the risk that the cancerous tissue spreads to other parts of the body, such as the abdomen and the pelvis. If this spread occurs it can substantially lower a patient’s chance for survival.

Currently, the FDA is reviewing the use of the power morcellation for the treatment of uterine fibroids. The FDA is implementing new policies and procedures to help reduce the inadvertent spread of unsuspected cancer to the abdominal and pelvic cavities.

Symptoms of Power Morcellator Side Effects

  • May spread an undetected or unsuspected uterine sarcoma
  • Tissues can be become implanted in organs
  • Other uterine cancers may form
  • Can worsen the prognosis for some patients.

Signs of Possible Power Morcellator Side Effects

  • Use discouraged for the treatment of uterine fibroids
  • Should not be used in women with suspected or known uterine cancer
  • Other treatment options should be reviewed prior to use
  • Risks and benefits should be discussed with your doctor
  • A specimen bag should be used to contain uterine tissue and minimize the risk cancer could be spread to the abdomen and pelvis.

Other Side Effects of Power Morcellator

  • Information released in 2014 identified several current steps the FDA was taking, including convening a public meeting of the Obstetrics and Gynecological Medical Device Advisory Committee. This committee discussed several issues including ways to improve the safety of using the power morcellation process while treating fibroids and whether there were new procedures which could be used to increase the safety and effectiveness of the product. The FDA also is considering whether product manufacturers need to add a boxed warning for the risks associated with the laparoscopic power morcellators. Finally, the FDA is evaluating information provided by patients, health care providers, gynecologic and surgical professional societies, and medical device manufacturers. In response to the FDA warning, Johnson & Johnson’s power morcellator manufacturing unit, Ethicon, ordered a voluntary withdrawal of their power morcellators from the market. Products which have been suspended worldwide include the the Gynecare Morcellex, Gynecare X-Tract, and Morcellex Sigma.

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