Hysterectomy

On Wednesday this week Dr. Oz spoke to his audience about fibroid disease, and the current status of the morcellator. We’ve been discussing morcellation here for several months since the FDA published their warning on it’s use.

Dr. Oz had a GYN surgeon who performs fibroid surgery using the morcellator, a patient who had cancer in her uterus during her surgery with the morcellator, and a physician who is against the use of the morcellator.  The discusses ranged from how to make the morcellator safer, to the tragic outcome of the patients cancer spreading after her surgery.

Watch the Dr. Oz videos HERE:

INTRODUCTION BY DR. OZ

Dr.Oz discusses the topic of morcellation during fibroid surgery and hysterctomy

DEMONSTRATION OF MORCELLATOR

A GYN surgeon demonstrates how a morcellator is used

DISCUSSION WITH PATIENT WHOS CANCER SPREAD DURING MORCELLATION

A patient who underwent morcellation during her surgery and had an undiagnosed cancer. Her cancer spread because of the morcellator.

DR. OZ SHARES HIS POSITION ON MORCELLATION

Dr. Oz states that he cannot support the continued use of the morcellator due to the increased risk of spreading cancer.

As we discussed a few months ago in a prior post, the FDA has warned against the use of the morcellators in GYN surgery. Now, the largest supplier of the morcellator devices to surgeons has withdrawn them from hospitals citing the risk of spreading an undiagnosed cancer.

You can read the full article here:  Wall Street Journal

During a laparoscopic or robotic surgery, a surgeon uses very small incisions to insert cameras and working instruments. Laparoscopic surgery has been around for more than 25 years and is performed for common surgeries such as gallbladders, prostates, etc. It has also been used for hysterectomy and myomectomy. The challenge with these two procedures is that the organ that is being removed is much larger than the incisions themselves.

So what do we do?!? In comes the ‘morcellator’:

This fancy little device  is used at the end of the surgery to break the uterus or the fibroid up into little pieces small enough to remove through the little laparoscopic holes which are made for the surgery. Without the morcellator, the surgeon would have to make an incision at least as large as the uterus or fibroid to remove it which would defeat the purpose of minimally invasive surgery.

The risk which has come to light with the use of the morcellator is in the very rare times when there is an unknown cancer inside a uterus or fibroid. By using the morcellator, that very small cancer can be broken up into many microscopic pieces which are spread throughout the abdominal cavity. Months or years later a women will develop metastatic (it’s spread) uterine cancer despite having had a hysterectomy.

Thus, the FDA has advised against use of the morcellator during Gyn surgery for this very reason. The Wall Street Journal published this article yesterday discussing the situation. More to come…. stay tuned as I’m sure this will evolve over the next months.