Power Morcellator Procedures
We hear the name of the surgical device known as the morcellator or power morcellator, and yet we don’t automatically make the connection between its function and its descriptive name. If we break it down we can recognize what it does just by scrutinzing its name. Morcel, or more properly spelled “morsel” means a small piece. And the suffix of -ator means “one that does”. So, it is a device that “does small bits”, or which divides and segments tissue into such small pieces that they can be laparoscopically removed.
Generally, it is only used for larger masses of tissue and is a way of helping to shorten recovery time by requiring only the smallest incisions in order to remove a larger amount of tissue. Rather than opening up a patient’s abdomen or making large cuts into muscle, the use of laparscopic tools such as the morcellator can really eliminate a lot of pain and wound complications.
However, recent headlines and safety communications from the FDA make it quite clear that morcellators may not be as great as initially believed.
In 2014, the FDA recommended that morcellators no longer be used during hysterectomy or myomectomy because of their demonstrated risks for spreading deadly cancer cells throughout the body. Additionally, it was determined that they are not 100% effective in removing diseased tissue, either, leading to a reoccurrence of cancer in the same region.
Also, surgeons have been using them in, “Laparoscopic renal (nephrectomy) or spleen (splenectomy) surgery.” And in some cases it was discovered that, “Benign or cancerous tissue spread to the abdomen in women or men, causing problems.” (DrugWatch.com, 2015)
This tells us that the devices have been used for gynecological procedures, as well as certain surgeries relating to the liver and spleen, and in many instances they have demonstrated a tendency towards spreading disease.
It does require a brief explanation to ensure that you comprehend the problem. Essentially, a morcellator is housed inside of a tube, and it features a blade that rotates and minces the tissue before allowing it to be suctioned away. While this seems like a very clean and precise way of handling the issue, it does allow small cells and bits of tissue to be easily spread throughout the body.
With certain forms of cancer (undetected or known), this works a bit like “seeding” and the cells migrate to other areas, adhere to tissue or cause cellular changes that lead to the development of cancer in previously healthy areas. In the case of Leiomyosarcoma, or LMS, this converts a relatively treatable form of cancer (that which was localized in the tissue being removed) to an almost untreatable form of systemic cancer.
Morcellators were deemed contraindicated for use in myomectomies and hysterectomies to remove fibroid tumors because of several deaths resulting from the spread of cancer. LMS is very resistant to chemotherapy and radiation, and when it has metastasized or gone systemic, it quite often proves untreatable and fatal. Thus, the morcellator is now becoming the least preferred tool of choice for such procedures.
Understanding the Risks of Morcellator Procedures
While a morcellator was long the preferred tool for closed hysterectomies and myomectomies, recent problems make it clear that there are risks in its use. While the shorter recovery time and reduced risks of wound problems are most definitely appealing, if you are told to have your fibroids removed, it is of the utmost importance to be sure they have been thoroughly screened for cancer, and LMS in particular. Some surgeons are still using the power morcellators for procedures of this kind, and the threat to your health remains real.
Drugwatch.com. Power Morcellators. 2015. http://www.drugwatch.com/morcellators/
Merriam-webster.com. -ator. 2015. http://www.merriam-webster.com/dictionary/-ator