Morcellators and Uterine Cancer
No matter the reason for it, a hysterectomy is a life-altering event. If you underwent a laparoscopic hysterectomy, you probably thought a minimally invasive procedure rather than a conventional hysterectomy was a plus. That may be the case, but if your doctor used a power morcellator on you to perform the surgery and you had undiagnosed uterine cancer, there’s a chance that the procedure could spread the disease throughout your body. Women who have undergone hysterectomies with a power morcellator are at risk for uterine cancer spread.
Power Morcellators By the Numbers
Approximately 600,000 women undergo hysterectomy each year in the United States, and half of those surgeries involve minimally invasive procedures. Of those 300,000 surgeries, about 12 percent involve power morcellators. Another 250,000 women undergo laparoscopic surgery annually for the removal of uterine fibroids, or leiomyomas. These growths form a round, rubbery mass on the uterine’s muscle tissue, and are most common during a woman’s childbearing years. Fibroids may cause excessive bleeding, pressure, and pain. Minimally invasive procedures to remove uterine fibroids do not require removal of the uterus. All together, about 60,000 women each year undergo uterine surgeries involving power morcellators.
According to the United States Food and Drug Administration (FDA), approximately 1 in 350 women undergoing laparoscopic hysterectomy or myomectomy – removal of uterine fibroids – are at risk for developing metastatic uterine cancer because of the use of the power morcellator. The FDA initially approved the use of power morcellation in 1991. The first such device marketed was the Cook Tissue Morcellator. In November 2014, the FDA issued a safety alert regarding morcellating devices and recommends against their use for most patients. One manufacturer, Johnson & Johnson, stopped selling its laparoscopic power morcellators. J&J’s products, part of its Ethicon division, include the Gynecare X-Tract Tissue Morcellator, the Gynecare Morcellex Tissue Morcellator, and the Morcellex Sigma Tissue Morcellator System. Cancer victims or their survivors have filed lawsuits against J&J and other power morcellator manufacturers.
How a Power Morcellator Works
A power morcellator looks like a drill, with blades instead of a drill bit. During the minimally invasive laparoscopic hysterectomy or myomectomy surgery, the physician creates a small incision. He then inserts a power morcellator and removes the uterus or fibroid tissue through cutting and shredding, removing the debris through the incision with a vacuum-like tube. Most women will have a much faster recovery than with conventional abdominal surgery, with less risk of complications. However, for those women with undiagnosed uterine cancer, especially sarcomas, the consequences of laparoscopic surgery may be deadly.
Uterine Cancer and Power Morcellation
Uterine sarcomas form in muscles of the uterus, as well as its supporting structures. Even though a woman who has had her uterus removed via power morcellation no longer has that organ, any cancer cells present at the time of the surgery have been spread throughout her body by the power morcellator’s actions. While uterine fibroids are benign, it is possible for them to include cancer cells. Unfortunately, because these cancers are usually aggressive and diagnosed at a late stage, the prognosis often is not okay, and few treatment options are available.
Power Morcellators and the FDA
The FDA notes that, currently, “There is no reliable method for predicting or testing whether a woman with fibroids may have a uterine sarcoma.” It warns power morcellation performed on women with undiagnosed uterine sarcoma might spread cancerous tissue within the pelvis and abdomen, “significantly worsening the patient’s long-term survival.” Power morcellator manufacturers must now include a boxed warning listing possible hazards on their product labels. The FDA also requires physicians to report any unsuspected cancer spread in women who have undergone power morcellation procedures for myomectomy or hysterectomy.
The FDA’s warning does not apply to hysteroscopic morcellators, a more recent device that includes pouches for collecting ground tissue. Since the tissue is preserved, it is available for cancer testing. To date, there are no studies linking this type of surgery to increased cancer risk.
Other Power Morcellation Surgeries
Power morcellators are also used in laparoscopic liver, spleen and gall bladder surgeries, putting men and women at risk of cancer spread. Spleen and gall bladder removal are often done with a power morcellator, as there is less bleeding involved and patients recover more quickly. Patients undergoing surgery via power morcellation are at risk for the spreading of non-cancerous pieces of tissue within the body. These bits can latch on to other tissues and organs, resulting in pain and requiring surgical removal.
Not All Laparoscopic Surgeries Involve Power Morcellators
Do not panic if you have undergone laparoscopic surgery and fear a power morcellator was used. The device is not used in common laparoscopic surgeries such as biopsies and tubal ligation because there is no need to shred considerable amounts of tissue. If you have undergone laparoscopic surgery, ask your doctor whether a power morcellator was used.
Side Effects of Power Morcellators
Cancer is not the only risk factor associated with power morcellators. Patients report other side effects caused by power morcellator use during surgery. This includes:
- abdominal and pelvic pain
- abscess formation
- bowel obstruction
- incision site pain
- internal organ damage
- muscular soreness.
- Uterine fibroid tissue may also grow back, requiring additional surgery.
Alternatives to Uterine Power Morcellation
The FDA states, “Health care providers and patients should carefully consider available alternative treatment options for the removal of symptomatic uterine fibroids.” Many insurance companies will no longer pay for routine surgeries performed using power morcellators because of the increased cancer risk and morcellator lawsuits. The American Congress of Obstetricians and Gynecologist (ACOG) recommends several alternative treatments to laparoscopic morcellation. These include:
- total abdominal hysterectomy
- vaginal hysterectomy – uterine removal through the vagina
- laparoscopic vaginal hysterectomy
- laparotomy – incision into the abdominal wall.
- ACOG stresses the need to warn patients about the potential of uterine cancer spread if power morcellation is used.
Contact a Power Morellator Attorney after Being Diagnosed with Uterine Cancer
By the time a woman receives a uterine cancer diagnosis after power morcellation, it may be too late. The cancer is generally at an advanced stage and inoperable. Even with health insurance, medical costs may be astronomical. These women, or their survivors, may be entitled to financial compensation. Women who have undergone a hysterectomy or myomectomy involving the use of a power morcellator and later received a uterine cancer diagnosis need legal advice. Call a personal injury lawyer to discuss your situation. An attorney can evaluate your case details and advise you of your legal options.
Call our law firm today or fill out our free case evaluation form. Our firm has a successful track record handling morcellator and uterine cancer cases.