Kochi, January 18, 2024: A vaginal reconstructive robotic surgery was performed for the first time in the state. The 23-year-old patient from Karur district in Tamil Nadu underwent the keyhole surgery at Apollo Adlux Hospital, Angamaly. The patient was born without a uterus, fallopian tube and vagina. On successfully undergoing the procedure, she was relieved of her symptoms and fertility issues caused by the condition. The two-hour procedure was lead by Dr Urmila Soman, Minimally Invasive Gynaecology, Robotic & Laparoscopic Surgeon and Dr Dinit Joy, Senior Consultant & HOD, Anaesthesia.
The patient was having MRKH – Type 2 syndrome a condition called Mullerian Duct Agenesis that caused agenesis of reproductive organs during fetal growth. Her uterus, tubes and vagina were absent but has two healthy ovaries due to their varied origin from genital ridges. These ovaries were placed above the pelvis. Additionally, the patient's right kidney was malpositioned as pelvic organ with an absent left kidney and ureter. Furthermore, the patient also had musculoskeletal abnormalities- syndactyly of her left thumb. Through robotic surgery, her absent vagina was reconstructed by creating a space between the bladder and rectum and lining it with a peritoneal flap. The ovary was repositioned to make it a pelvic ovary.
“Though the patient cannot conventionally conceive, surrogacy is possible through IVF. On employing robotic surgery, the challenge posed by the malpositioned pelvic kidney was tackled, ensuring precision and preventing damage to the kidney. The team of doctors also refrained from the conventional vaginal reconstruction which is equally complicated and painful, hence conducting a robotic surgery.” said Dr. Urmila Soman, Senior Consultant & Robotic surgeon. The procedure went smoothly and the patient was discharged 2 days post-surgery.
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