Adapting surgical skills from robotic-assisted radical hysterectomy in cervical cancer to uterine transplantation: a look to an optimistic future!

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.