A groundbreaking surgical technique known as uterine transposition is emerging as a vital option for women undergoing radiation therapy in the pelvic region, allowing them to preserve their fertility. Dr. John Paul Diaz, chief of gynecologic oncology and director of robotic surgery at Baptist Health, emphasized the potential of this procedure to enhance patients’ quality of life.
Dr. Diaz, who leads the Clinical Trials in Gynecologic Oncology at Miami Cancer Institute, explained that uterine transposition is particularly beneficial for patients with colorectal or gynecologic cancers undergoing radiation treatment. This surgical approach involves relocating the uterus to the abdominal wall, away from the radiation-affected areas, demonstrating an innovative mindset among surgeons in the field.
At Baptist Health, part of the MSK Alliance, Dr. Diaz has leveraged his training and ongoing collaboration with experts at Memorial Sloan Kettering Cancer Center (MSK), including his mentor, Dr. Mario M. Leitao, Jr. This partnership has facilitated the successful introduction of uterine transposition in South Florida. “We have already performed this procedure on two patients,” Dr. Diaz noted. “Our first patient has completed her radiation therapy, and we have successfully repositioned her uterus and ovaries back into the pelvis. She is currently three months post-op and doing well, with hopes of future pregnancy. Our second patient is in the midst of her radiation treatment, with stage two of her procedure planned for later this year.”
Dr. Diaz outlined the critical short- and long-term outcomes for patients undergoing this surgery. In the immediate post-operative period, one key indicator of success is the perfusion of the uterus, which is assessed using indocyanine green dye to confirm blood flow. Short-term goals include the absence of complications and continued healthy perfusion, which would allow for the uterus to be safely re-implanted into its normal position. Ultimately, the long-term aim is for patients to achieve remission and a successful live birth.
Despite the promise of this technique, Dr. Diaz acknowledged challenges in raising awareness among healthcare providers. “It’s crucial that physicians recognize uterine transposition as a viable option,” he stated. “We are actively reaching out to colorectal and gynecologic surgeons to ensure they can identify potential candidates and refer them to specialized care.”
Looking ahead, Dr. Diaz emphasized the need for broader awareness and education about this innovative procedure. While the initial description of uterine transposition dates back nearly a decade, its adoption in the U.S. is just beginning to take shape. “It’s vital for physicians treating patients with pelvic tumors to inform them about this fertility-preserving option prior to initiating cancer treatment,” he said. “We are committed to advancing surgical techniques and expanding access to this life-changing procedure, enabling more women to retain their fertility post-cancer diagnosis.”
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