Surgical Film Library-Uterine Transposition

Video Transcription

Video Summary

The speaker discusses uterine transposition, an innovative surgical technique designed to preserve fertility in patients undergoing pelvic radiation for cancers like rectal and cervical cancer. Radiation often causes infertility due to ovarian and uterine damage. Uterine transposition involves laparoscopically moving the uterus to the upper abdomen before radiation, then repositioning it back to the pelvis afterward. The procedure is based on knowledge from radical trachelectomy and ovarian transposition, aiming to maintain uterine and ovarian function. Detailed surgical steps include vessel ligation, extensive mobilization, and securing the uterus and ovaries to the abdominal wall. Early trials involving 14 patients showed promising results with preserved hormonal function and menstrual cycles, though complications like uterine necrosis, cervical stenosis, and one cancer-related death occurred. Pregnancy rates remain limited with ongoing studies evaluating safety and efficacy. The speaker emphasizes uterine transposition is experimental, recommended only within clinical trials, with further research needed on fertility outcomes and oncologic safety.

Asset Subtitle

Reitan Riberio, Canada

Meta Tag

Procedure Type Uterine transposition

Route MIS-Laparoscopic

Skill Level Expert

Surgical Location Pelvis

Keywords

MIS-Laparoscopic

Pelvis

Expert

Uterine transposition

fertility preservation

pelvic radiation

laparoscopic surgery

oncologic safety