Here is another in our continuing series of articles about things going on around Rochester
Last spring, Rochester healthcare facilities pulled a popular medical device used to perform hysterectomies, procedures that remove the uterus as a way to treat uterine fibroids, after it was found to spread hidden cancers in some women. However, that does not mean doctors have stopped performing the procedure altogether. They’ve simply found other ways.
Power morcellators cut tissues, like fibroids, into small pieces, which are then extracted. Sometimes, though, pieces of tissue are left behind. If a women has undetected cancerous tissues, morcellation can cause the previously undetected cancers to spread throughout the body, catastrophically worsening the patient’s condition.
When it was discovered that power morcellators were doing this, the health care industry scrambled to take care of the issue. Although it did pose a huge risk, morcellation was still seen as a viable route for many patients, which gave decision makers pause when determining what to do.
UR Medicine issued guidelines last March that permitted power morcellation, just so long as it was done within in a containment bag.
“[O]ur providers have essentially discontinued using power morcellation as new information has emerged. We will, of course, comply with the recall as requested by the manufacturer,” said Dr. Eva Pressman, head of obstetrics and gynecology at UR Medicine, in a statement.
In April, Rochester General and Unity hospitals suspended use of power morcellation, and, according to a statement from the hospitals’ owner, Rochester Regional Health System, would send them back to their manufacturer.
That same month, the Food and Drug Administration vehemently discouraged the medical devices use, and Johnson and Johnson, which manufactured about 70% of the morcellators used worldwide, suspended sales of the device.
Then in November, the FDA announced that it would not outright ban morcellators, but that the agency was recommending manufacturers put a boxed warning on the device, which claimed that uterine tissues may contain unsuspected cancers and “the use of laparoscopic power morcellators during fibroid surgery may spread cancer and decrease the long-term survival of patients.” The announcement said the warning “should be shared with patients when considering surgery with the use of these devices.”
Now, about a year since the crisis first began, doctors are finding ways to provide hysterectomies, without the use of power morcellators.
Doctors at Unity Hospital, which has banned power morcellation as previously mentioned, are performing mini-laparotomies, procedures that remove the uterus intact through the vagina, and in the case of too-large fibroids, doing open surgery.
“It’s still how we do C-sections these days, you know, and people are fine,” said Sareena Fazili, a gynecologist at Unity, adding that the morcellator didn’t always work on large fibroids, which forced doctors to make a large incision anyway.
So it seems that although the methods have changed, women are still able to get the procedures they need, now without the risk of hidden cancerous tissues spreading.