Uterine transplant surgery is now supported by robotic surgery and has infact, resulted in a successful pregnancy. The breakthrough developed in Gothenburg makes the procedure much less invasive on patients. A woman is now pregnant, expecting a spring delivery as a result of a robotic-assisted surgery, conducted in 2017.
"I think robotic surgery has a great future in this area," says Mats Brännström, Professor of Obstetrics and Gynecology at Sahlgrenska Academy, University of Gothenburg, and world-leading researcher in the field. The surgery is still in its research phase which allows for a maximum of ten surgeries to be completed.
New surgery assist donor
The fifth and sixth of these have been completed with the others likely to happen all in 2019. There have been eight births in Sweden after useful uterine transplants using the traditional open surgery.
The new surgery mainly affects the donor who instead of undergoing traditional open surgery only requires 5 ‘keyhole’ sized incisions one centimeter long. The surgeons then operate highly precise robotic arms using joystick-like controls. The two surgeons sit with their heads close to their respective covered monitors some distance from the patient.
A hand movement from the surgeon can be converted to a millimeter-sized movement in the donor's abdomen. Once the uterus is released it is extracted it is then inserted into the recipient using traditional open surgery.
“We haven't saved as much time as we thought we would, but we gained in other ways. The donor loses less blood, the hospital stay is shorter, and the patient feels better after surgery," Brännström says.
Baby born from deceased donor in Brazil
So far in the research, the donors have been relatives, often mother and daughter or sometimes close friends. Research into using the uterus from deceased donors is becoming more viable.
Last year the first baby was born from a post-mortem uterus in Brazil. For some women receiving a uterus, transplant is the only way to get pregnant. However, getting donations has is very difficult due to the invasiveness of the surgery and the need for a perfect match.
So far worldwide a total of thirteen babies have been born after regular uterine transplantation. Eight of these have been born under the Sahlgrenska Academy research program in Gothenburg, two children have been born in the United States and one child in each of Brazil, Serbia, and India.
In December last year, scientists reported the first successful birth of a baby from a transplanted uterus from a deceased donor. The birth mother and donor-recipient was a 32-year-old woman who was born without a uterus as a result of Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome.
The donor was a 42-year-old woman who died from a stroke. Several months before the transplant the recipient went through an IVF procedure and had 8 fertilized eggs frozen. The uterus transplant took 10.5 hours to complete. The robotic-assisted surgery and the possibility of using organs from deceased donors open the possibility for more uterus transplantation surgeries.