Laparoscopic hysterectomy using a surgical tool called a power morcellator doesn’t improve outcome over other minimally invasive options for surgery, and because of the risk of spreading undetected cancer, the American College of Obstetricians and Gynecologists says vaginal hysterectomies using robots are the best option.
Both manual laparoscopy and robotic surgery operate through small incisions, which offers shorter recovery time and less scaring than open surgery. During both types of procedures to remove the uterus or just uterine fibroids, some doctors also use a handheld surgical tool called the power morcellator. The tool is typically used with a tube-shaped blade that grinds up the uterine growths or entire uteruses so they can be pulled through the smaller incisions.
In recent years, more people have undergone procedures using power morcellators. But that number is quickly dropping since the Food and Drug Administration (FDA) last April warned that the devices could spread undetected cancer, worsening the odds of survival.
In 2013, concerns were first being raised about the device. There is no way to detect a type of uterine cancer known as uterine sarcoma before the tumor or uterus is removed. Once ground inside the body by the morcellator, bits of cancerous tissue can seed inside the body, planting aggressive tumors.
Many doctors have stopped using the devices because of the risk. One major manufacturer of power morcellators, Johnson & Johnson, has discontinued sales of its device based on concerns. But some doctors say the benefits outweigh the risks, and they don’t intend to stop using them.
The FDA recommends that women who have undergone hysterectomies or myomectomies using power morcellators keep regular appointments with their doctors even if their tests following surgery turned out normal. Women who have symptoms of uterine cancer – such as unusual bleeding, pelvic pain or a mass in their pelvic region – should consult with their doctors.
Women who have undergone procedures with power morcellators who have uterine sarcoma are advised to consult with an attorney, as they may have a case against the manufacturer of the devices.