Carbonnel Marie, Dahm-Kähler Pernilla, Revaux Aurelie, Brännström Mats, Ayoubi Jean-Marc
Department of Obstetrics and Gynecology, Foch Hospital, Suresnes, France.
Department of Obstetrics and Gynecology, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
J Robot Surg. 2020 Dec;14(6):841-847. doi: 10.1007/s11701-020-01058-7. Epub 2020 Feb 22.
Uterus transplantation (UTx) is the first treatment for absolute uterine factor infertility. The first birth after human UTx in Sweden occurred in 2014 and very favourable results of the Swedish trial performed with laparotomy raised great hope. Several teams are leading their own trial among the world, but UTx is still in its experimental phase. Surgical intervention needs to be optimized. The long surgical duration (> 10 h), vascular dissection and risks of ureteral damages for live donors are major drawbacks. Minimal invasive surgery by means of robotic-assisted laparoscopy for live donors could become an improved option. Our collaborative Swedish-French team has initiated efforts to introduce minimal invasive surgery in one trial in Sweden and one in France. UTx is somewhat similar to a radical colpohysterectomy for arterial dissection. We describe a robotic-assisted radical colpohysterectomy and its transposition to uterus retrieval in a living donor. We report our experience on nine cases that were completed prior to our French UTx robot-assisted trial.
子宫移植（UTx）是治疗绝对子宫因素不孕症的首选方法。2014年，瑞典首例人类子宫移植术后诞生了婴儿，瑞典开腹手术试验取得的非常良好的结果带来了很大希望。世界上有几个团队正在开展各自的试验，但子宫移植仍处于实验阶段。手术干预需要优化。手术时间长（>10小时）、血管解剖以及活体供体输尿管损伤风险是主要缺点。对活体供体采用机器人辅助腹腔镜进行微创手术可能会成为一个更好的选择。我们瑞典-法国合作团队已着手在瑞典和法国的一项试验中引入微创手术。子宫移植在动脉解剖方面与根治性阴道子宫切除术有些相似。我们描述了一种机器人辅助根治性阴道子宫切除术及其在活体供体子宫获取中的应用。我们报告了在法国子宫移植机器人辅助试验之前完成的9例病例的经验。
