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Power Morcellation Risky, Even With Benign Disease

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Bonnie Harp3 years ago

According to Medscape, John Hopkins has released three case reports indicating that power morcellation can induce benign uterine disease, putting patients at risk for more disease and extensive surgery.

What is Morcellation?

Laparoscopic power morcellation is a surgical technique that is often used to treat uterine fibroids. During power morcellation, a medical device will divide uterine tissue into small pieces in order for removal through small incisions, such as through the abdomen or vagina.

Uterine fibroids are benign and nonthreatening masses that grow from the smooth muscle tissue of the uterus.  However, uterine fibroids can require surgery due to uncomfortable side effects like heavy menstrual bleeding and pelvic pain.

The use of power morcellation in the context of malignant uterine tumors has been discouraged for some time. However, the Food and Drug Administration (FDA) issued warnings against its use in benign cases as well due to data revealing its connection to uterine sarcoma.

Uterine sarcoma is a rare type of uterine cancer that occurs mainly within the pelvis and abdomen.

In November, the FDA reinforced their earlier warnings against laparoscopic power morcellation, stating that it should not be used in women receiving a hysterectomy or myomectomy for uterine fibroids. A black box warning was implemented on the label of power morcellators to warn clinicians of its potential risk to spread cancerous properties through the peritoneal cavity.

About the John Hopkins Morcellation Studies

John Hopkins Hospital conducted a study of three women who had recently experienced power morcellated hysterectomies for uterine fibroids. They were studied within 6-12 months post-surgery.

  • Case 1
    • Subject: 38-year old mother of 4
    • Symptoms: abdominal pain, constipation, elevated CA-125 level
    • Multiple soft tissues were removed from spleen, colon, diaphragm, omentum, ureters and ovaries.
  • Case 2
    • Subject: 51-year-old mother of 2
    • Symptoms: abdominal pain, pelvic pressure, painful urination
    • A 15-cm mass was removed with resection of pieces of ureters, bladder, colon, omentum, ovary and fallopian tube.
  • Case 3
    • Subject: 51-year-old mother of 2
    • Symptoms: nausea, vomiting, abdominal pain, bowel obstruction, pelvic mass
    • The mass was removed along with her ovaries and fallopian tube.
  • Results indicated high suspicion of cancerous properties.
  • Researchers strongly recommend surgeons to inform all patients of the risks of power morcellation.


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