(New York Times) – A power device used during uterine surgery in at least 50,000 women a year in the United States risks spreading cancerous tissue and should no longer be used in “the vast majority” of women, the Food and Drug Administration said on Monday.
The tools, laparoscopic power morcellators, have been widely used in operations to remove fibroid tumors from the uterus, or to remove the entire uterus. Morcellators cut tissue into pieces that can be pulled out through the tiny incisions made during minimally invasive surgery.
The safety concern is that women who undergo these operations sometimes have undiagnosed cancer, and morcellators have rapidly spinning blades that can fling malignant cells around inside the abdomen and “upstage” the disease to a more advanced and deadly form. Fibroids themselves are benign but can hide uterine sarcomas, an aggressive type of cancer that can be rapidly fatal once it spreads.
In one in 350 women having fibroid surgery, biopsies after the operation find previously undetected sarcomas, the F.D.A. estimates. The risk of this cancer increases with age. Morcellating a sarcoma, the agency said, “may spread cancer and decrease the long-term survival of patients.”