Medical Devices – Morcellators

The National Institutes of Health says one in every three American women will undergo a hysterectomy.

According to the U.S. Department of Health and Human Services, after Caesarian section, which is the number one surgical procedure that doctors perform on women in the US, hysterectomy comes next. Doctors consider hysterectomy, a surgical procedure aimed at removing a woman’s uterus, safe and very effective in eliminating or reducing uncontrollable vaginal bleeding and chronic pelvic pain, and in treating certain types of infections and cancer (such as cancer of the uterus, ovarian cancer or cervical cancer). Furthermore, hysterectomy is performed due to various needs and reasons, including

  • Removal of (uterine) fibroids, which are benign tumors that develop in the uterus
  • Treatment of:
    • Pelvic inflammatory disease (an infection of the female reproductive organs)
    • adenomyosis (a condition wherein the uterus’ inner linings protrudes through the muscle wall of the uterus)
    • uterine prolapse (a condition in which the uterus, or womb, slips out of the cervix, dropping halfway into the vagina (or birth canal)
    • endometriosis (a source of pain and bleeding due to the growth of the inner lining of the uterus in the abdomen)

There are different ways of removing or treating the uterus, through: Abdominal Hysterectomy (where a vertical or horizontal cut is made in the abdomen); Laparoscopic Hysterectomy (multiple minimal incisions are made, one for the laparoscope, or small camera, to see inside the body as the uterus is cut and removed in small pieces); Vaginal Hysterectomy (wherein a cut is made inside the vagina instead of in the abdomen); and, Laparoscopically Assisted Vaginal Hysterectomy or LAVH (a procedure that uses a laparoscope to guide the removal of the uterus, ovaries and/or fallopian tubes through the birth canal.

In laparoscopic surgeries an instrument, called a morcellator, is used to mince large masses of tissues (can be the uterus or uterine fibroids) for easy extraction. A morcellator is usually used in supracervical hysterectomy, which leaves the cervix untouched. When used in hysterectomy or myomectomy (removal of uterine fibroid), however, a morcellator can cause the spreading of uterine sarcoma, a cancerous tissue that is very hard to detect. Due to this risk, the US Food and Drug Administration issued a safety alert that discourages the use of morcellators in the said surgical procedures.

Despite the fact that hysterectomy and myomectomy, wherein morcellators are used, are much faster and safer to perform, require shorter recovery time and greatly reduce any possibility of infection compared to vaginal or abdominal hysterectomy and myomectomy, these do not outweigh the harm (cancer) that patients can be made to suffer from.

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Adolescence and Depression

Researchers and physicians recommend that children and adolescents stay under close watch when they are taking prescription medication. Since the developing brain makes neural connections at an accelerated rate, compared to the adult brain, the effects of medication can be extremely defining to continued brain development. Though a healthy majority of young people do not experience overwhelming symptoms of depression, some young people find prescription antidepressants extremely helpful in allowing them to be productive, focused, and regain their vitality.

Adolescents are particularly vulnerable to situational depression, like the after effects of divorcing parents, a sudden death, or complications from moving away from their original home. In addition to being vulnerable to situational changes, adolescents also deal with extreme pressures within competitive academic avenues, competitive friend groups, and shifting hormone levels. Many adolescents that are in need of therapeutic assistance for depression or anxiety are extremely hesitant to be vulnerable in asking for help.

Many young people affected by depression or anxiety might not even be aware that their condition is abnormal, accepting sadness as a normal state of being. Prescription antidepressants, like Lexapro, Zoloft, and Prozac, coupled with psychiatric therapy, have proven to be a very effective form of treatment for depression and anxiety. Urges to self-harm and thoughts of suicide are hosted most commonly in the thoughts of younger people, so doctors are warned to pay extra attention to their younger patients on antidepressants. The Food and Drug Administration (FDA) administered black box warnings for all antidepressants. Black box warnings are the strongest possible issuing that the FDA can administer. Boxed warnings indicate that the prescription may carry a significant level of risk to patients. Specifically, warnings for antidepressants emphasize the possible risks for birth defects to developing fetuses as well as increased thoughts of suicide.

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