Two Boston hospitals are reviewing their approach to a surgical technique commonly used in hysterectomies following two medical cases that have led to debate on the potential cancer risks associated with the procedure.
The technique, called morcellation, is characterized by a surgeon shredding tissue, usually fibroids or the uterus, during a laprascopic hysterectomy that is then usually removed through a small incision in the abdomen.
Both Massachusetts General Hospital and Brigham and Women's Hospital in Boston are revising their guidelines and informed consent policies regarding the procedure.
Both hospitals are making changes in part due to two medical cases in which women had undetected cancer spread into their abdomen following the procedure.
One woman, Dr. Amy Reed, 41, is an anesthesiologist at Beth-Israel Hospital in Boston. Now suffering from stage IV cancer, Reed and her husband, Dr. Hooman Noorchashm, a cardiothoracic surgeon at Brigham and Women's, have started a Change.org petition and written letters to try and stop doctors from performing the procedure because they say it is too dangerous.
Medical experts say that the procedure has long been appealing to patients because a laparoscopic hysterectomy with morcellation means a faster healing time for patients and minimal scaring, compared to an abdominal hysterectomy, which involves opening the abdominal cavity.
The American College of Obstetrics and Gynecology (ACOG) said that the chance of spreading the virulent and deadly cancer, leiomyosarcoma, through morcellation is "rare." However, the ACOG said the risk for other cancers spreading through morcellation is not clearly known.
According to ACOG, 498,000 hysterectomies were performed in the U.S. in 2010 and the chance of discovering leiomyosarcoma through surgery is 1 in 2000.
Many women, including Reed, have hysterectomies due to uterine fibriods that can cause irregular menstrual bleeding, pelvic pressure or pain.
Sometimes doctors are able to just break up and remove fibroids and leave the uterus intact by using morcellation in a similar laparoscopic procedure.