Boston Hospitals Review Hysterectomy Technique After Cancer Concerns


Two Boston hospitals are beginning to change protocol after reviewing risks of spreading cancer through morcellation – a surgical technique sometimes used during laparoscopic hysterectomy. Morcellation involves the shredding of tissue, typically uterine fibroids, during laparoscopic hysterectomy. The tissue can then be removed through a small incision in the abdomen.

The reviews were prompted by two reported cases involving women who experienced undetected cancer spreading into their abdomen following morcellation, according to an ABC News report. Concern soon became widespread. One of the women, a 41-year-old anesthesiologist from Boston, and her physician husband have even gone as far as creating a petition to prevent surgeons from performing morcellation because they claim it is too dangerous.

Treating certain conditions with morcellation has been effective for many patients. Many medical experts have noted that the approach is also appealing because it offers fast recovery time and minimal scarring in comparison to more traditional surgical approaches. Still, as with any surgery, there are risks.

Risks of Spreading Undetected Cancer

The American Congress of Obstetrics and Gynecology (ACOG) has stated that the chances of spreading leiomyosarcoma – a deadly cancer – are quite rare. However, ACOG has acknowledged that the risks of morcellation spreading other types of cancer are not clearly known. Statistics also reveal the following:

  • ACOG reported 498,000 hysterectomies in the U.S. in 2010
  • The chance of discovering leiomyosarcoma through surgery is approximately 1 in 2000

In light of the two reported cases and the attention they have drawn, medical experts at two Boston hospitals have adopted the approach of providing full disclosure about these risks to patients – the risks of undetected cancer possibly spreading through morcellation. They have also suggested a policy to not perform morcellation in women who are at a higher risk of having undetected cancer, including women in older age groups.

Why Evaluating Risks & Understanding Options is Important

There is still much to learn about cancer risks and morcellation. A large part of the problem involves the fact that tests performed before a hysterectomy do not identify these cancers well. Due to the nature of the uterus and uterine fibroids, no test can definitively prove a patient doesn't have an undetected tumor. Reviews of cancer risks will be ongoing, but already they have helped revise guidelines about informed consent. They are also increasing awareness about the real, albeit rare, possibility of undetected cancer spreading. Physicians and patients concerned about these risks should have multiple tests performed and should always consider all available options.

The review makes it clear that finding as much information as possible, including second opinions, is essential. Women should make every effort to consult with experienced surgeons who can work personally with them to evaluate any potential risks and all available treatment options. Hysterectomy.com is a resource you can use along your journey, and one that can connect you to a leading expert in laparoscopic surgery, hysterectomy, and related female conditions – Dr. Tamer Seckin.

If you are located in New York, the tri-state area, or wish to travel to New York to meet personally with Dr. Seckin, make an appointment or call (888) 885-8311.