Use of power morcellation for hysterectomy on the decline

Electric power morcellation during hysterectomy can spread unknown cancer cells, which led to an FDA recommendation to stop doing it.

By Stephen Feller

NEW YORK, N.C., Aug. 23 (UPI) -- Although they were not used in most hysterectomies, the use of electric power morcellators in the procedures has declined significantly since the U.S. Food and Drug Administration recommended against them two years ago, report researchers in New York.

Researchers at Columbia University found the use of morcellators dropped by nearly 80 percent after the FDA suggested they be phased out over concerns they could spread unknown cancer when used, according to a study published in the Journal of the American Medical Association.


Electric power morcellators are used in procedures involving the uterus being fragmented into smaller pieces during laparoscopic hysterectomies.

With several studies raising concern the devices may increase the risk of spreading unknown cancerous cells to other parts of the body, the FDA in 2013 first warned doctors of the potential safety risk. Months later, they fully recommended the devices no longer be used.

The agency based its recommendation on estimates that 1 in 350 women undergoing hysterectomy or myomectomy has an unsuspected uterine sarcoma, a type of cancer that can be difficult to detect. Using morcellation, they said at the time, can cause cancerous tissue to spread in the abdomen or pelvis.


To determine if doctors heeded the warning, researchers at Columbia University College of Medicine identified 117,653 women in the Perspective medical database -- which covers about 500 hospitals in the United States and 15 percent of all hospitalized patients in the country -- who underwent minimally invasive hysterectomy.

In 2013, just before the FDA issued its initial warning, about 13.5 percent of hysterectomy patients underwent power morcellation, a number that increased to 13.7 percent after the warning at the end of 2013. The researchers found, however, that use of the device in procedures dropped to 2.8 percent of by the beginning of 2015.

"The FDA warnings might result in a lower prevalence of cancer among women who underwent morcellation due to greater scrutiny on patient selection," researchers wrote in the study. "However, the high rate of abnormal pathology after the warnings highlights the difficulty in the preoperative detection of uterine pathology. Continued caution is needed to limit the inadvertent morcellation of uterine pathology."

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