More surgical "woo." Gynecological surgeons added this procedure to their repertoire [View all]

[pnwmom]

more than 20 years ago, without any research demonstrating its safety and effectiveness.

Since then, the procedure of morcellation -- usually using an electric medical device -- has been performed on more than a million patients with fibroid tumors in their uteruses, and in other organs as well.

http://www.nytimes.com/2014/02/07/health/uterine-surgical-technique-is-linked-to-abnormal-growths-and-cancer-spread.html

Uterine Surgical Technique Is Linked to Abnormal Growths and Cancer Spread

Concerns are increasing among doctors about the safety of a procedure performed on tens of thousands of women a year in the United States who undergo surgery to remove fibroid tumors from the uterus, or to remove the entire uterus.

The procedure, morcellation, cuts tissue into pieces that can be pulled out through tiny incisions. The technique is part of minimally invasive surgery, which avoids big incisions, shortens recovery time and reduces the risks of blood loss, infection and other complications.

Surgeons can perform morcellation by hand with a knife, or with an electrical device that has a rapidly spinning blade. But problems have emerged with the procedure, most likely from the power device, according to two articles published on Thursday in The Journal of the American Medical Association. The technique can spray bits of uterine tissue or fibroids around inside the abdomen like seeds. Even benign tissue (fibroids are benign) can take hold and grow on organs where it does not belong, causing pain, infection or bowel obstruction.

In a few cases, a rare and hard-to-diagnose uterine tumor called a sarcoma was hidden in the uterus or mistaken for a fibroid, and morcellation apparently spread cancer cells through the patient’s abdomen. Advanced cancer followed.

SNIP


http://en.wikipedia.org/wiki/Morcellator

Morcellation devices in surgery

Laparoscopic morcellation is commonly used at surgery to remove bulky specimens from the abdomen using minimally invasive techniques. Historically, morcellation was performed using a device that required the surgeon or assistant to manually 'squeeze' the handle. Other reports describe using a scalpel directly through the abdomen to create small specimens that can be drawn out of the abdominal cavity. In 1993, the first electric morcellator was introduced in the US market. It was initially used for uterine extraction, but later applied to other organs. The use of morcellators at surgery has now become commonplace, with at least 5 devices currently on the US market. Despite decades of experience, there remains limited understanding of the short-term and long-term sequelae of morcellation. Concerns have been raised about injury to surrounding organs including bowel, bladder, ureters, pancreas, spleen and major vascular structures. Long-term issues may include parasitic growth of retained tissue with the potential to cause adhesions, bowel dysfunction and potentially disseminate unrecognized cancer.