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Why is morcellator discouraged during a hysterectomy?

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The use of a laparoscopic power morcellator during a hysterectomy is discouraged because it increases the risk of spreading cancerous tissue within the abdomen and pelvis, according to the FDA in 2014. This can significantly reduce a patient's long-term survival following a hysterectomy.

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During a hysterectomy with morcellation the surgeon slices the uterine tissue into small pieces and extracts them with a laparoscope through an incision in the abdomen. In women with undetected uterine cancer, the morcellator cuts through cancerous tissue and potentially distributes it outside the uterus, as reported by CBS News. A medical study from 2006 to 2012 indicated that 27 out of 10,000 women having a morcellation procedure had unknown uterine cancer at the time of the procedure. The chance of having undetected uterine cancer increases with age, with the highest rates in women over 65. The FDA estimates that one in 350 women having a hysterectomy also have a uterine sarcoma, a rare cancer that occurs in connective tissues.

Approximately 500,000 hysterectomies are performed annually in the U.S. to treat conditions including fibroids and uterine cancer, according to CBS News. Alternative procedures are available that do not use morcellation. A 2014 FDA safety notice recommended that women discuss all available options with health care providers and specifically inquire whether morcellation is planned in treatment procedures.

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