In a world first, a baby boy has been born following a uterus transplantation achieved solely by robot-assisted surgery on both donor and recipient.
The baby, measuring 49 centimetres and weighing 3kg and 100 grams, was delivered by planned caesarean section last week, said the team from the Sahlgrenska University Hospital at the University of Gothenburg in Sweden, in a statement.
The child, the 35-year-old new mother, and the donor, who is a relative are all doing well, the doctors said.
In the breakthrough surgery, the donor and recipient alike were operated on entirely by means of robot-assisted laparoscopic (keyhole) surgery — considered less invasive than traditional open surgery.
The transplantation via robot was carried out at Sahlgrenska University Hospital in October 2021. In the donor, the uterus was freed one step at a time, supported by robot surgery. The last step involved detaching the uterus from its blood vessels and removing it vaginally in a laparoscopic pouch.
The uterus was then inserted into the recipient woman’s pelvis through a small incision; first it was stitched with the blood vessels; and then stitched to the vagina and supportive tissue. All these steps were assisted by robot surgery.
“With robot-assisted keyhole surgery, we can carry out ultra-fine precision surgery. The technique gives a very good access to operate deep down into the pelvis. This is the surgery of the future, and we’re proud and glad to have been able to develop uterine transplantations to this minimally invasive technical level,” said principal surgeon Pernilla Dahm-Kahler, adjunct professor of obstetrics and gynaecology at Sahlgrenska.
Ten months later, an embryo created by in vitro fertilisation (IVF) before the transplantation was inserted in the transplanted uterus, and a few weeks later pregnancy was verified.
The mother-to-be felt well throughout her pregnancy, which has thus now concluded with a planned C-section in the 38th week, the doctors said.
“With the robot assisted technique procedures can be done that were previously considered impossible to perform with standard keyhole surgery. It is a privilege to be part of the evolution in this field with the overall goal to minimise the trauma to the patient caused by the surgery,” said Niclas Kvarnstrom, the transplant surgeon in charge of the research project.
The transplantation represents a further development of the uterus transplantation surgery that began with open-surgery technique in Sweden 2012.A
“This is the 14th baby born in the uterus transplantation project at Sahlgrenska Academy, and more births are awaited this summer. The research project continuously evaluates numerous variables in donors, recipients, and children after the uterus transplantation, following up the operation for several years afterward,” said Mats Brannstrom, Professor and doctor of obstetrics and gynaecology at Sahlgrenska.
“All this is done to maximise the efficacy of the operation and minimise side effects in the patients,” he added.
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