In an unprecedented operation in Uruguay, they changed the position of the uterus to a 26-year-old patient with vulvar cancerso that the radiotherapy does not affect fertility. The intervention was performed at the National Institute of Orthopedics and Traumatology of Uruguay, belonging to the Public Health system.
The surgery was also used as part of medical training in Uruguay and was broadcast live for students and doctors. The idea is that this type of operation can be replicated and performed on other young women who have to undergo radiotherapy or other aggressive cancer treatments.
In all cases where a woman is treated with radiotherapy for cancer in the abdominal area, she loses her ability to fertilize eggs naturally. That is why in many cases they are urged to carry out a process of extraction of the gametes from it, prior to the treatments. To later be able to be biological mothers.
If she so desires, this 26-year-old girl, successfully operated, will be able to gestate normally, according to the doctors. But in addition, she will not see her menstrual cycle affected, which will result in a better general quality of life from a medical point of view. Since she will have the hormonal process of any patient her age.
Normally the surgery takes about 90 minutes, but in this case it was closer to two hours. When the radiotherapy ends, this young woman must be operated on again to position the uterus in her place.
What is the operation about?
Uterine transposition consists of “changing the position of the uterus. Remove it from the uterine cavity and temporarily place it in the abdominal cavityin such a way that it moves away from the radiation zone and preserves its functions”, according to what he explained to the newspaper The country Dr. Marianna Gilardoni.
Joel Laufer, a gynecologist who participated in the operation, told Underlined that “in recent years advances in cancer treatments have increased and the preservation of fertility is part of the quality of life of patients.”
With this operation, the uterus is raised to the area above the navel, so that the radiotherapy does not irradiate it. “What we do is remove it from the pelvis and place it outside the field of radiotherapy, placing it at the level of the anterior wall of the abdomen”, where it will be for the duration of the cancer therapy.
Approximately 18 cases have been carried out in the world. “There are three live births in the world, with this technique,” said the Uruguayan gynecologist.
This surgery performed in Uruguay was designed by doctor and professor Reitan Ribero from the Paraná Gynecology Hospital, Curitiba, Brazil. The Uruguayan professionals who were studying the case of this young woman decided to contact the Brazilian professor to request his assistance. The doctor agreed to travel to Uruguay for a day, to perform the operation and teach the technique to his Uruguayan colleagues.
Doctors from the “C” Gynecology Clinic of the University of the Oriental Republic of Uruguay, associate professor and doctor Gonzalo Sotero and doctor Joel Laufer also participated in the surgery.
It was performed at the Multipurpose Surgical Center of the National Institute of Orthopedics and Traumatology of Uruguay, located in the city of Montevideo. The space has the necessary infrastructure and equipment, not only for the intervention but also for filming and broadcasting the procedure to students and professionals of the gynecology department.