A baby boy carried in a womb implanted into his mother by a robot was born in a world first.
The boy, who has not been named, weighed six pounds and 13 ounces when he was born via planned cesarean section in Sweden last month. Both the child and his 35-year-old mother are doing well.
The pregnancy was made possible when a family member agreed to donate their uterus to the mother, who then had a fertilized egg implanted in it through IVF. The case marks the first time robots have been used for the proceedings.
It will bring hope to the tens of thousands of American women who do not have a uterus – which could be due to cancer or a medical condition – or who are unable to carry babies.
Surgeons used robots to perform the surgery in Sweden, which are less invasive and reduce the risk of developing an infection
The case was revealed by surgeons at the University of Gothenburg, Sweden, a leader in uterine transplants.
In surgery, researchers began by removing the uterus in the donor by gradually cutting it away from blood vessels and pulling out the vagina.
Small incisions were made in the second patient’s side, near the pelvis, and the uterus was implanted therein. It was connected to their blood vessels and vagina.
Surgeons placed cameras and robotic arms with surgical instruments attached through the small access holes in the lower abdomen to perform the procedure – with the robotic arms being the first for this type of surgery.
The arms were controlled via joysticks, with surgeons using consoles that allowed them to see 3D images of the inside of the patient at the same time.
This method is less invasive than the standard uterine transplant, which opens larger openings in patients.
It is also thought to reduce the risk of infections and bleeding and allow patients to return to their daily lives more quickly.
The transplant took place in October 2021 at Sahlgrenska University Hospital, also in Gothenburg, Sweden.
Ten months later, an embryo was created through IVF before being placed in the transplanted uterus, and the pregnancy was confirmed a few weeks later.
The expectant mother felt good during her pregnancy, which has now ended at the end of May 2023 with a planned cesarean section in the 38th week.
Pernilla Dahm-Kähler, an adjunct professor of obstetrics and gynecology at Sahlgrenska Academy, University of Gothenburg, was the chief surgeon in the complicated recipient surgery.
She said: ‘Robot-assisted keyhole surgery allows us to perform ultra-fine precision surgery.
‘The technique provides very good access to operate deep into the pelvis. This is the surgery of the future and we are proud and happy that we have been able to develop uterine transplants to this minimally invasive technical level.’
Dr. Pernilla Dahm-Kähler said they could perform ultra-fine surgery with robots. Dr. Niclas Kvarnström added: ‘The robot-assisted technique allows procedures to be performed that were previously considered impossible with standard exploratory surgery.’
Dr. Niclas Kvarnström, the transplant surgeon who performed the complicated suturing of blood vessels on the recipient, added: ‘The robot-assisted technique allows for procedures that were previously thought impossible with standard keyhole surgery.
“It is a privilege to be part of the evolution in this field with the overall goal of minimizing trauma to the patient caused by the surgery.”
The work is led by Mats Brännström, Professor of Obstetrics and Gynecology at Sahlgrenska Academy, University of Gothenburg, and Gynecologist and Senior Consultant Physician at University Hospital.
He said: ‘This is the 14th baby born in the uterus transplant project at Sahlgrenska Academy, with more births expected this summer.
‘The research project continuously evaluates numerous variables in donors, recipients and children after the uterus transplant, and then follows up the operation for several years.
“All this is done to maximize the effectiveness of the surgery and minimize side effects in the patients.”
About one in 5,000 women in the US is born with a genetic condition that means they don’t have a uterus.
Women may also have a uterus that is structurally incapable of holding a developing fetus. It may also be necessary to remove it because of conditions such as uterine cancer, which affects about 3,300 women under the age of 40 each year.
Uterine transplants have been available to women since 2014, although no robotic arms are used.
To date, a total of 33 have been performed in the US, with the majority completed at Baylor University Medical Center in Texas.
An estimated 90 uterine transplants have been performed worldwide and about 50 babies have been born.
Past patients include mother-of-five Aprill Lane, who donated her own uterus at age 39 so another woman could have children.
The research group has further disseminated the methods and techniques through direct knowledge transfer to various centers around the world.