Standard Operating Procedures (SOPs) are in place, duties have bee assigned, mock drill has been done, operation theatres are being fumigated, infrastructure is ready, and 180 hospital staff members have been put on high alert.
Preparations at Galaxy Care Laparoscopy Institute (GCLI) are in full swing as Pune gets ready for country’s first uterus transplant surgery, which is scheduled on Thursday (May 18). Doctors, nurses, ward boys and non-medico staff are all set to carry out one of the most complex procedures.
“The atmosphere in the hospital is positive. We have been eagerly waiting for this day as it is like a dream come true for us. We are fully prepared and committed,” said Dr Shailesh Puntambekar, who is leading the team at GCLI.
When asked about stress, he said they cannot afford to be stressed.
“We are psychologically prepared, we know, we have the expertise under our belt, we will perform,” said Dr Puntambekar.
Speaking to My Medical Mantra, Dr Puntambekar said, “As of now, our priority is to focus on patients’ mental health. They are also positive about this surgery. In morning, we had a good chat with patients to keep up their moral.”
One of the patients is a 21-year-old who was born without a uterus and is delighted for the surgery.
“Among the four siblings, she is the only one whose uterus is absent by birth. The smile on her face that she will be able to bear a child in future is what is driving us since the time we decided to carry out this surgery,” the doctor added.
As per the procedure, stomach of the donor and the recipient has been cleaned. They have been put on anti-organ suppression medicines since Wednesday morning so that, the body will not reject foreign object. All four operation theatres have been fumigated, intensive care units (ICUs) have also been sterilised.
Dr Puntambekar added, “We have removed more than 40 uteruses till now, but now we have to join the new one. My team knows there is no margin of error, so the SOPs have been laid down. We have also conducted a ‘mock drill’ of each and every step to be carried out on Thursday.”
Uterus transplant is a complicated and time consuming procedure. Doctors will take four hours to remove the uterus from the donor and will take 3 hours more for the transplant. Once inside the operation theatre (OT), no doctor will leave the OT till the operation is over.
Meanwhile, the most worrisome factor for the doctors is the power supply as Thursday is load-shedding day wherein electricity in hospitals across Pune is not supplied.
Dr Puntambekar said they have informed the Maharashtra State Electricity Board (MSEB) about the surgery and it has agreed to cooperate. The chief engineer briefed the hospital on May 17 and will be present on Thursday as well.
Barely few hours from now, the judgment day will begin wherein the doctors know there is zero margin of error and with their determination and commitment they will sail through to make India proud.
About the patients
- This surgery will attempt to fit three women with wombs of their mothers and a successful womb transplant will allow them to bear their own children.
- While one of the three Pune candidates has a congenital absence of uterus, another one has scarring (adhesions) of uterus (Asherman’s syndrome) and the third woman’s uterus was removed due to cancer three years ago.
- The donors are their own mothers and the first transplants are going to be conducted for free.
- With the three women volunteering for the operation, it will be conducted for free.
- A patient’s mother or sister can be a uterus donor. Age of the donor should not be more than 55 years and the donor should be infraction-free.
“There are a number of girls who don’t have uterus due to failed uterus or either they were removed during a cancer treatment or a girl born without a uterus. They all have equal right to bear their own child. If a lady has decided to have her own child, then who are we to stop her from doing so? We are not competing with anybody here, we are just providing her an option with new available technology,” said Dr Puntambekar.
- Preparation for the surgery
- State’s directorate of health services granted license to Pune’s Galaxy Care Laparoscopy Institute (GCLI) to carry out uterus transplant.
- Globally, around 25 surgeries are attempted, of which less than 10 successful post-transplant pregnancies are known. First one was in Sweden in 2014.
- A team of 12 doctors, they are specialised in different fields of medicine. Every morning at 8, they would assemble and discuss the procedure in length.
“We have been doing this for years now. In India, we are going to perform this for the first time and we are prepared for the task. We have received tremendous support from the government. A team of doctors had a close look at our hospital and its infrastructure. The team had stayed in our hospital for over a month to make sure that everything is in place before granting us a permission to carry Uterus transplant procedure,” Dr Puntambekar.
About uterine transplant
- It is a surgical procedure whereby a healthy uterus is transplanted in the woman whose uterus is absent or diseased.
- A diseased or absent uterus prohibits normal embryonic implantation, thereby rendering a woman infertile.
- This phenomenon is known as absolute uterine factor infertility (AUFI). Uterine transplant is a potential treatment for this form of infertility.
- In Turkey, on 9 August 2011, world’s first uterus transplant from a deceased donor was conducted by a team of doctors at Akdeniz University Hospital in Antalya.
- The 21-year-old Turkish woman, Derya Sert, who had been born without a uterus, was the first woman in history to receive a womb from a deceased donor.
- In October 2014, it was announced that for the first time, a healthy baby had been born to a uterine transplant recipient, at an undisclosed location in Sweden.
- The British medical journal The Lancet reported that the baby boy had been born in September, weighing 1.8 kg (3.9 lb) and that the father had said his son was “amazing”.