The most controversial and severe side effect associated with use of a morcellator is the spread of cancer. In cases where the surgeon uses a morcellator to remove affected tissue, small pieces of the cancerous tissue may spread to other, unaffected areas. In such cases, the infected tissue grows and implants itself, affecting the surrounding tissue as well.
Due to this, many women with no knowledge of having cancer before a hysterectomy or similar procedure done using a morcellator have been diagnosed with late-stage cancer within several weeks after the procedure. The types of cancer that have spread using morcellators include uterine sarcoma, myelosarcoma, uterine cancer, and leiomyosarcoma (LMS). It is currently impossible to detect uterine cancer in the early stages, making it impossible to screen out those at risk of the cancer spreading.
The FDA estimates that around 1 out of 350 women who undergo uterine fibroid removal or a hysterectomy will have some form of unsuspected uterine sarcoma. Each of these women will have a drastically decreased chance of survival if morcellation is used during the removal of fibroids or the uterus, as this may speed up the spread of the disease.
It is possible to reduce the risk of disease spreading by utilizing a protective surgical bag, but these are flimsy and difficult to use. Therefore they represent an increased challenge with no guarantee that they will be effective.
An additional side effect of the morcellator is the possibility of abnormal tissue growth, which occurs via a similar process to the spread of cancerous cells. Small pieces of broken-up tissue may be implanted on organs or other tissue instead of removed. When this occurs, it can lead to further complications, including death, in cases where the doctor does not discover the tissue in time.
There is also a risk of a morcellator damaging healthy tissue during the procedure. This risk is minimized when the device is used by a skilled surgeon, but anytime that the device slips slightly, it can affect nontargeted tissues, greatly damaging them in the process.
A further risk associated with the use of a morcellator is that the doctor may accidentally leave behind a small section of the tissue. This is essentially what occurs in the case of abnormal tissue growth or the spread of cancerous cells in that a power morcellator makes the pieces so small that surgeons may easily miss a piece of tissue, particularly if the power from the morcellator spreads it to another area.
The FDA has recognized that the side effects of the morcellator are serious and as of April 2014 recommended that it not be used until further research has been conducted to determine the frequency of the above side effects.