Power morcellators are devices that enable doctors successfully perform surgeries requiring tissue removal through a small incision. These devices, sometimes called electric morcellators, perform a majority of the cutting in laparoscopic and robotic surgeries.
The devices are fitted with rotating blades that break down large tissues into small fragments that can in turn be vacuumed out of the body, enabling the doctor to work through an incision less than 2 cm in size. These types of surgeries and subsequent incisions, allow doctors to avoid large incisions through core stomach muscle which leads to quicker recovery, reduced post-op pain and fewer surgical site complications.
However, this convenience has come at a price. As the device works to break up tissues for removal, pieces may become implanted on abdominal structures and organs.
For example, many women who have undergone renal surgery (nephrectomy), splenic surgery (splenectomy), hysterectomy or myomectomy, in which a power morcellator was used, have since developed conditions such as fibroids, endometriosis and adenomyosis, thus requiring additional surgery. Those also harboring undiagnosed uterine cancers can suffer from the spread of malignant tissues throughout the abdominal cavity, resulting in leiomyosarcoma, endometrial stromal sarcoma, carcinosarcoma, and endometrial adenocarcinoma.
The FDA issued a safety communication in April of 2014, discouraging doctors from the use of power morcellators for the removal of the uterus and uterine fibroids during laparoscopic procedures. Numerous insurance companies responded to the statement, refusing to pay for morcellation surgery without prior authorization, adding that there are safer alternatives for women. Hospitals scrutinized these devices as well, with many large chains banning their use. In response, Johnson & Johnson immediately suspended worldwide sales of its laparoscopic power morcellators.