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Morcellator Use Faces New Challenge

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Surgeons have more tools at their disposal these days than ever before, which generally works out for the benefit of the public. That being said, sometimes a piece of technology can actually be more trouble than it’s worth. Despite how popular it’s been in the past, the morcellator is considered to an example of one of these devices by many in the medical profession. Now, a growing group of health insurers here in the U.S. are taking steps to limit the use of the laparoscopic power morcellator. This move came as the result of federal regulators warning it wasn’t safe for use on most women.

The Power Morcellator

The power morcellator may be used for a couple different procedures. Typically, though, a gynecologist will use them for hysterectomies, though myomectomies are common too.

These devices became popular because of their ability to do some of the necessary, but often difficult, cutting during the procedures. On one end, there’s a grip for the doctor to hold the morcellator, then there is a long tube protruding off it, finished by rotating blades. Due to how tiny the device is and the reach of the tube, morcellators have made it easy for surgeons to break down large tissue into much smaller fragments. Once that’s done, a vacuum is used to clear the pieces.

With just two centimeters of space, the doctors can use a morcellator to gain access to the fibroids in need of removing. This saves the surgeon from having to make large invasive cuts and the patients from having to recover from them.

The Problem with Morcellators

While it’s obvious that these machines bring a lot to the table, there’s a reason the FDA warns against their use and now insurers are stepping forward to speak up against their use.

For one thing, it’s been proven that morcellators aren’t 100% effective in getting rid of the tissue they target. It’s much worse than that though. If there is any cancerous tissue around the area where the morcellator is getting used, its spinning blades could shred it up. Unless the vacuum is able to get rid of those torn up cancer cells, the morcellator actually helped spread them throughout the body. As a result, women can actually develop cancerous tumors after their surgery.

According to a quantitative analysis of data currently available, the FDA estimates that roughly one out of every 350 women who undergo a hysterectomy or a myomectomy due to fibroids also have an undiagnosed uterine sarcoma. For these women, having a morcellator used on them in surgery could turn out to be a deadly decision.

Precautions by the FDA

While the FDA hasn’t actually outlawed the use of power morcellators, they have definitely cautioned physicians about their use. All of these machines now come in boxes with labels across them that remind doctors of what could happen when they’re used.

Insurers Step In

As we mentioned earlier, insurers in the US are now demanding tighter regulations regarding these instruments. According to a trade group within the industry, America’s Health Insurance Plans, the dangers related to these tools both have to do with how they are made, what they are used for and how they are monitored after being sold.

Three of the four biggest insurers in the country are amongst many that have already taken steps to curtail the use of these tools for the roughly 93 million their plans cover. According to America’s Health Insurance Plans, the number of doctors using them is already dropping.

Although they clearly have their benefits, given the risks involved and the powerful groups working against them, it would seem as though morcellators won’t see widespread use very soon.

Sources:

http://www.wsj.com/articles/more-health-insurers-take-action-to-limit-morcellator-use-1428009386

http://www.wsj.com/articles/health-insurers-call-for-stronger-rules-on-medical-devices-1429129995