Abstract
Background: The surgical approach and choice of drainage veins for uterus transplantation living-donor surgery have been investigated to reduce invasiveness. Methods: A thorough search of the PubMed database was conducted. The search was not limited by language or date of publication. The data were collected on 13 October 2020. Two reviewers independently assessed each article and determined eligibility for inclusion in the review article. Inclusion criteria were English peer-reviewed articles reporting surgical information or postoperative course, articles regarding animal research on UTx, UTx on deceased donors, or not original articles. Results: Of the 51 operations within 26 articles reviewed, the mean operative time was shortest in the laparoscopic approach, and longest in the robot-assisted approach. The mean blood loss was less in the laparoscopic and robot-assisted approaches than in the open approach. In cases where the uterine veins were not preserved, the mean operative time was shortened by each approach and the mean blood loss decreased with the laparoscopic and robot-assisted approaches. Conclusions: These procedures may contribute to less invasive living-donor surgery.
Highlights
Absolute uterine factor infertility (AUFI) includes congenital uterine malformation and defects, such as Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome [1], which occurs in one in 5000 women; acquired uterine defects caused by treatment of uterine cancers or hysterectomy due to puerperal bleeding; extended uterine myomatosis; and Asherman’s syndrome, in which the endometrium is adhered [2]
In this review of the literature, we report on the differences in surgical and clinical outcomes by the variation of surgical approach and the preserved veins in UTx living-donor surgery
The uterine veins were not used for transplantation, even though they were preserved and removed from the donor in a Czech case
Summary
The surgical approach and choice of drainage veins for uterus transplantation living-donor surgery have been investigated to reduce invasiveness. Methods: A thorough search of the PubMed database was conducted. The search was not limited by language or date of publication. Inclusion criteria were English peer-reviewed articles reporting surgical information or postoperative course, articles regarding animal research on UTx, UTx on deceased donors, or not original articles. Results: Of the 51 operations within 26 articles reviewed, the mean operative time was shortest in the laparoscopic approach, and longest in the robot-assisted approach. The mean blood loss was less in the laparoscopic and robot-assisted approaches than in the open approach. In cases where the uterine veins were not preserved, the mean operative time was shortened by each approach and the mean blood loss decreased with the laparoscopic and robot-assisted approaches. Conclusions: These procedures may contribute to less invasive living-donor surgery
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