5 years ago

Laparoscopic Assisted Uterus Retrieval From Live Organ Donors for Uterine Transplant

The authors present the first ever laparoscopic assisted uterus retrieval in live donor for uterus transplant. Design A step-by-step surgical demonstration Setting Galaxy CARE Laparoscopy Institute, Pune, India Patient(s) Two patients, ages 21 and 26 with Mayer Rokitansky Kuster Hauser (MRKH) syndrome and Ashermann's syndrome respectively, with their mothers as donors. Intervention(s) A Twelve member team was formed. After review of available literature on uterine transplant a protocol was formulated and submitted to the IRB. Approval from the Institutional Review Board was obtained. Thorough screening of candidates was done. Two consecutive uterine transplants were done on two successive days. Vessels were harvested laparoscopically in both donors. To prevent damage to the harvested vessels, Uterus was retrieved by taking a small abdominal incision. Uterus was transplanted in the recipients by end to side anastomosis of the harvested vessels to external iliac vessels, followed by anchoring of supports of the donor uterus to those of the recipients. Main Outcome Measure(s) Surgical intra and post operative parameters, post operative investigations and follow up data of 4 months. Result(s) Operative time for laparoscopic donor surgery was 4 hours. Bench surgery took 45 mins. Recipient time was 4 hours. There were no intra operative or immediate post operative complications. Both recipients attended menses after 34 days and 48 days respectively and have had 3 cycles of menses at regular intervals till date. After discharge follow up cervical biopsies at 3 weekly intervals showed no signs of rejection. Uterine artery Doppler showed good flow in both patients. Conclusion(s) Laparoscopic assisted donor retrieval is feasible and affords all advantages of minimally invasive technique. It helps in better dissection of vessels, shortens operative time and helps minimize tissue handling, thereby reduces the morbidity of the procedure

Publisher URL: www.sciencedirect.com/science

DOI: S1553465017312736

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