For the first time worldwide, in yet another breakthrough by the world-leading research team at the University of Gothenburg, a child has been born following a uterus transplantation achieved solely by robot-assisted surgery on both donor and recipient.
The baby, a boy measuring 49 cm and weighing 3100 grams, was delivered by planned caesarean section on May 25. The mother is 35 years old, and the donor is a relative.
What distinguishes this case is the surgical method used in the transplantation itself. This time, the donor and recipient alike were operated on entirely by means of robot-assisted laparoscopic surgery with no open-surgery stage.
Robotic surgery is considerably less invasive than traditional open surgery, enabling patients to recover faster.
In the present case, the transplantation 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.
In the recipient, it was then possible to insert the uterus into the woman’s pelvis through a small incision; first suture it with the blood vessels; and then suture it to the vagina and supportive tissue. All these steps were assisted by robot surgery.
Ten months later, an embryo created by in vitro fertilization 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 now concluded with a planned C-section in the 38th week.
Pernilla Dahm-Kähler, adjunct professor of obstetrics and gynaecology at Sahlgrenska Academy, University of Gothenburg, is also a gynaecologist and senior consultant doctor at Sahlgrenska University Hospital. As the principal surgeon in the intricate operation on the recipient, she describes the technique: “With robot-assisted keyhole surgery, we can carry out ultra-fine precision surgery. The technique gives 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.”
Niclas Kvarnström was the transplant surgeon in charge on the research project, and the one who performed the complicated blood-vessel suturing in the recipient.
“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 minimize the trauma to the
patient caused by the surgery,” he said.
The transplantation represents a further development of the uterus transplantation surgery that began with open-surgery technique in Sweden in 2012. The work is headed by Mats Brännström, professor of obstetrics and gynaecology at Sahlgrenska Academy, University of Gothenburg, and gynaecologist and senior consultant doctor at the University Hospital.
