Robotic Assisted Uterine Transposition: A Feasible Option for Young Women with Pelvic Cancers

Estimates predict that there will be an increase in pelvic tumors among young women under the age of 45 in the next 20 years. This trend is linked to a cultural shift that is pushing the age of conceiving a first child to later in life. These types of tumors often require chemoradiotherapy treatments. Ovarian function may be preserved through ovarian transposition, whereas techniques for uterine displacement (e.g., uterine suspension, ventrofixation, and transposition) have been recently proposed to maintain endometrial functionality. Among these options, uterine transposition has proven to be the most effective strategy in preventing the organ from being exposed to the pelvic irradiation field. However, it is also the most complex option from a surgical standpoint. Robotic surgery is experiencing an increase in its global use, due to its benefits in the management of complex cases and due to the easy integration of new technologies (e.g., artificial intelligence, image-guided surgery, and augmented reality). Currently, among uterine displacement techniques, the robotic approach is used to perform uterine transposition in selected cases. Future studies with larger samples are required to evaluate the efficacy of uterine transposition and to assess whether the less complex surgical techniques of ventrofixation/suspension are equally effective with a reduced risk of complications.