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Leiomyosarcoma And Power Morcellators

Disposable Laparoscopic Morcellator

In light of recent FDA findings and suggestions around the use of laparoscopic devices and morcellators for hysterectomies and myomectomies, there have been many who wonder how to best perform certain gynecological surgeries. After all, the FDA’s findings are valid – the rotating blade of the typical morcellator is exposed and allows the tissue to be dispersed easily. This is the heart of the problem, and it is why large manufacturers of morcellators, such as Johnson & Johnson, voluntarily recalled their gear after the second FDA safety communication.

Disposable Laparoscopic Morcellator

Interestingly enough, even as the news was breaking early in 2014, a patent for a “disposable laparoscopic morcellator” had long been on file. This is a device that effectively eliminates most of the risk posed by classic morcellators, and yet it does not demand the use of a containment bag as most suggest is the only solution.

Q: What is the disposable laparoscopic morcellator?

A: It is similar to many other types of morcellators with one major distinction: “A laparoscopic grasping instrument is inserted through the lumen and draws the tissue proximally through the morcellator. As the cutting member severs tissue, the tissue is drawn into the fixed lumen of the inner tube.” (Google, 2015)

In other words, rather than using the spinning blade to segment and shred tissue in the open body cavity, this new device suctions it into a tube in which it can then be more neatly severed and contained. It gives the surgeon complete control over the tissue and cuts down on the risk of any missed tissue, as well.

Q: Just how does this work?

A: The disposable laparoscopic morcellator has been designed for removing large masses of tissue. It features a rotationally fixed, and yet axially movable inner tube that is disposed within the cutting chamber. This is radically different from other models that position the cutting device between the inner and the outer tube.

In essence, if you were to watch the device at work, you would see that it allows a physician to position the chamber adjacent to the mass in need of removal. The device then pinches the mass and the outer tube is then positioned over it. The cutting device is then used to sever the tissue, and the inner tube consistently shelters it and protects the surrounding tissue from damage or exposure.

Q: Can the disposable laparoscopic morcellator provide physicians with the kinds of wide margins that are needed for the most effective outcomes?

A: While most surgeons want to see smaller margins, when it is a matter of uterine tissue affected by cancer, the margins must be between one to two centimeters for optimal satisfaction. This device would give the surgeon that range of control and allow them to clearly see the area in question prior to the cutting.

Q: Does this eliminate the risks that other morcellators pose?

A: It does reduce them, but cannot yet fully eliminate them. It must be understood that the typical morcellator does not allow a surgeon the kind of targeted controls that this design provides. It contains and removes larger masses rather than segmenting them and suctioning up pieces. This alone presents are far superior alternative that can cut down on the risk or threats to a patient who may see their cancer spread if cells are dispersed freely. However, there is still the risk of some contamination.

This new design is an improvement on the current devices at work. However, the FDA has not yet found anything that it can advocate in the way of morcellation devices. Until that time, it is best to discuss all options with the surgeon.

Source Patent US6039748. 2015.