Should Women Still Undergo Power Morcellation?

Boston, MAGiven the apparent risk of power morcellation side effects and power morcellation lawsuits filed alleging women were harmed when their hysterectomies involved morcellation, the question must be asked whether or not women should still be subjected to morcellation during their surgery. That's the question Amy Reed and Hooman Noorchashm are asking, and it's a deeply personal one. That's because Reed, herself a doctor, underwent surgery to remove a uterine fibroid and wound up with rare cancer in her uterine wall.

Since she had her operation in 2013, Reed has undergone four operations to remove the tumors that were reportedly spread throughout her abdomen thanks to the power morcellation. According to Boston magazine (3/16), the companies that sell power morcellators put the odds of what Reed went to at around one in 10,000. But Reed says that for women who need surgery to remove fibroids the odds are actually one in 350.

Power morcellation is used to break up uterine tissue in women who are having hysterectomy or myomectomy for uterine fibroids. Breaking the uterine tissue up makes it easier to remove through a small incision, putting the patient at a lower risk of blood loss or infection. But in women who have uterine sarcoma—which is not detected until after the surgery—power morcellation effectively breaks up the cancerous tissue and spreads it within the abdomen, decreasing the long-term survival rate.

The FDA has issued a warning that the use of power morcellation could be linked to the spreading of a rare cancer. Since that time, according to reports, the use of power morcellators has dropped drastically. That drop, Reed notes, has not resulted in an increase in complications during hysterectomy, which some morcellation proponents warned would happen.

In other words, using power morcellators during hysterectomy may not actually decrease the risk of complications as much as previously believed.

Reed's data comes from a study done by researchers from Columbia University, who examined the use of power morcellators in hysterectomies. During the first quarter of 2013, 13.5 percent of minimally invasive hysterectomies used power morcellators. By the first quarter of 2015 that percentage had dropped to 2.8 percent. At the same time, there was no increase in the rate of hysterectomy complications but the rate of women who were found to have uterine cancer after surgery remained around one in 350.

Johnson & Johnson has withdrawn all its Ethicon morcellation devices, but power morcellators are still used in some minimally invasive surgeries. Lawsuits filed against the makers of power morcellation devices allege the companies knew or should have known about the risks associated with the use of power morcellators.