Power Morcellators, Postmarketing Surveillance, and the US Food and Drug Administration

Power morcellators are laparoscopic surgical devices that use electromechanical energy to cut solid tissue specimen into smaller pieces, thereby allowing minimally invasive hysterectomy and myomectomy for large uteri and fibroids. Power morcellator devices were first described in 1993 and were widely adopted by gynecologists. Supporting their use was evidence that laparoscopic hysterectomy has advantages over abdominal hysterectomy, including less blood loss, less postoperative pain, more rapid recovery, fewer wound infections, and shorter hospitalizations. Uptake of the new technology was rapid. From 2005 to 2013, the rate of outpatient laparoscopic hysterectomy increased from 31.4 to 161.6 per 100,000 adult women, whereas the rate of inpatient hysterectomy declined from 172.1 to 72.1 per 100,000 adult women. According to one report, at their peak usage, power morcellators were being used in an estimated 55,000 to 75,000 procedures annually in the US. Here, Redberg et al discuss the disadvantages of power morcellator devices.