World’s First Birth Following Uterus Transplantation With Robot-Assisted Surgery Alone

Robotic surgical procedures are significantly less invasive compared to conventional open surgeries. This approach involves the introduction of cameras and robotic arms equipped with surgical instruments through tiny openings in the lower abdomen. Surgeons then manipulate these robotic arms using joystick-like devices at workstations, where they can simultaneously view dynamic 3D images and perform operations with high accuracy. In various surgical procedures, robotic surgery has demonstrated reduced infection and hemorrhage risks. Generally, patients treated with this method recover more swiftly. Now, for the first time in the world, in a breakthrough by a research team at the University of Gothenburg (Gothenburg, Sweden), a child has been born after a uterus transplantation done solely using robot-assisted surgery on both donor and recipient.

What sets this case apart is the surgical technique utilized in the transplantation itself. In this instance, both the donor and recipient were operated on solely via robot-assisted laparoscopic surgery, without any open-surgery phase. This transplant was done in October 2021. With the aid of robotic surgery, the uterus was detached from the donor one step at a time. The final step was the detachment of the uterus from its blood vessels and its vaginal extraction in a laparoscopic pouch. The recipient was then able to receive the uterus through a small incision in her pelvis. The uterus was first attached to the blood vessels, then to the vagina and supportive tissue - all steps were robot-assisted. Ten months later, an embryo, produced through in vitro fertilization prior to the transplant, was implanted in the transplanted uterus, and pregnancy was confirmed a few weeks later. The expectant mother remained in good health throughout her pregnancy, which concluded with a planned C-section in the 38th week.

Image: A child has been born following uterus transplantation achieved solely by robot-assisted surgery (Photo courtesy of University of Gothenburg)

“With robot-assisted keyhole surgery, we can carry out ultra-fine precision surgery,” said Pernilla Dahm-Kähler, adjunct professor of obstetrics and gynecology at Sahlgrenska Academy, University of Gothenburg, is also a gynecologist and senior consultant doctor at Sahlgrenska University Hospital. “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.”

“With the robot assisted technique procedures can be done that were previously considered impossible to perform with standard keyhole surgery,” said Niclas Kvarnström, the transplant surgeon in charge on the research project, and the one who performs the complicated blood-vessel suturing in the recipient. “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.”

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University of Gothenburg