Morcellation

Morcellation is a surgical technique that divides a large mass of tissue into smaller pieces so it can be removed through the small incisions used in laparoscopic surgery, using an instrument called a morcellator, a hollow cylinder with sharp edges or cutting jaws. The first electric morcellator reached the United States market in 1993 for removing the uterus and uterine fibroids, and the technique later spread to other organs, with at least five devices sold in the United States. It carries a safety risk because an unsuspected cancer such as leiomyosarcoma can be present in about one in a thousand cases of apparently benign gynecologic tissue removed this way, and morcellating an undetected cancer can spread it inside the body; in April 2014 the FDA discouraged morcellator use in uterine procedures over this risk, after which Johnson and Johnson suspended and then withdrew its morcellators from the market.