Embolization May Be Effective Alternative Over Morcellation For Uterine Fibroid Removal

Following recent concerns about the risk of spreading cancer during laparoscopic morcellation, new research suggests that an alternative treatment for uterine fibroid removal may provide a safer and effective option. 

According to a study presented at the Society of Interventional Radiology’s annual meeting in Washington, D.C. on Monday, a technique known as embolization is under-used by the medical profession, and could be an alternative means of getting rid of uterine fibroids, instead of laparoscopic hysterectomies that may involve the use of a power morcellator.

Power morcellators are a medical device that became increasingly popular over the past decade for minimally invasive hysterectomy procedures, allowing surgeons to cut up and remove the uterus and uterine fibroids through a small incision in the abdomen. However, the procedures have been largely abandoned due to the risk that morcellators may spread undiagnosed cancer cells contained in the uterus, rapidly upstaging aggressive cancers like leiomyosarcoma.

Embolization is an alternative treatment for uterine fibroids, which has been around for more than a decade and involves injecting particles into uterine fibroids to choke off their supply of nutrients, causing them to shrink. According to lead researcher, Dr. Prasoon Mohan, of the University of Miami, the technique is minimally invasive, cheaper, and results in a shorter hospital stay than other forms of uterine fibroid removal.

According to the findings of the study, which have not yet been published for peer-review, there were about 78,200 hysterectomies for fibroids in 2013, which was down from 168,000 in 2007. However, there were less than 2,500 embolization procedures conducted in those same years.

Mohan indicates that each patient’s case is different and the correct procedure should be based on the individual circumstances and preferences. However, he indicated that he believed the embolization procedure is under-utilized. As more surgeons and hospitals avoid minimally invasive laparoscopic hysterectomy procedures due to the morcellation risks, embolization may provide another alternative.

In November 2014, the FDA decided to add a black box warning to power morcellators about the cancer risk, and provided guidance on the limited instances where laparoscopic hysterectomies may be warranted.

Since those warnings were issued by federal regulators in April 2014, the medical community has largely abandoned the use of morcellators, and Johnson & Johnson’s Ethicon unit, which was previously the main manufacturer of the device, stopped selling the tool.

Johnson & Johnson has faced dozens of hysterectomy morcellation lawsuits brought on behalf of women who suffered upstaged uterine cancer after a laparoscopic procedure, and wrongful death claims by family members who had died of such cancers, alleging that the device was defective and unreasonably dangerous. While most of those cases have been resolved through morcellator settlement agreements, a number of other morcellator manufacturers continue to face claims alleging that they failed to warn the medical community about morcellator risks.