Uterus transplant: ‘Motherhood is an instinct, instincts can’t be questioned’

Dr Shailesh Puntambekar, who led a 12-member team, to perform India's first uterus transplant speaks exclusively to My Medical Mantra about the procedure, ethical dilemmas and India’s surgical prowess

My Medical Mantra Exclusive: From the OT of India's first uterus transplant surgery
Team of doctors performing India’s first uterus transplant

A 12-member team headed by Dr Shailesh Puntambekar conducted India’s first uterus transplant on a 21-year-old from Solapur on Thursday (May 18, 2017). Speaking exclusively to My Medical Mantra, as he prepares for another such surgery later in the day, the director of Galaxy Care Laparoscopy Institute (GCLI), Pune, said it’s time for India to show its true potential in the field of medicine.

My Medical Mantra Exclusive:From the OT of India's first uterus transplant surgery
Dr Puntambekar and team performing the surgery

My Medical Mantra (MMM): You performed India’s first uterus transplant surgery. What prompted you to make this move? What do you have to say to the myriad opinions surrounding the procedure?

Dr Shailesh Puntambekar (SP): Organ transplant is the way forward. We have now established a procedure that comes as a hope for people who choose to bear children naturally.

There are women who are born without uterus and there are those who have had the organ removed due to certain complications. This does not mean they cannot have biological children. What was considered impossible in India till a day ago is now possible. We have the best medical practitioners and state-of-art techniques in our country, and it’s time to make the best of them.

Organs such as liver, kidney, eyes, heart and lungs have been transplanted for decades. Uterus transplant is another step towards advancement in surgery. In medical science, we should always have a futuristic point of view. We have to keep brainstorming about ways forward.

MMM: Has it been your dream to perform a surgery like this?

SP: I wouldn’t put it in those terms. If I have to put it in words, the best way I can evaluate is this is how surgeons evolve with years of experience. I have done several operations in the past, including those where I have removed uteri. Then I thought to myself, if I can remove a uterus, why can’t I transplant it? And I should be able to do so with the technology available to me. We spent years in doing research and working out the minutest details before actually doing the surgery.

Today I am proud that we at GCLI are performing this procedure. This is something the whole world can emulate. Why to follow the west? Why to be a follower?  We should try and be the originator.

MMM: What is the condition of the donor and the recipient? What about the concerns with regards to organ rejection?

SP: The mother-daughter duo is stable now. The donor (mother) will be in hospital for two or three days, while the stay will be longer for the recipient – the next two weeks. We really cannot predict anything about organ rejection. As a doctor I can only keep hope. We have done our best.

MMM: There have been several voices within the medical fraternity about choosing surrogacy over uterus transplant. What is your opinion on this?

SP: Like I said earlier, I am not here to fight or compete; I am not a judge. If a woman wants to have a child of her own, I mean gestational and biological child, then as a doctor how can I ask her to opt for surrogacy or other means? My only aim was to establish a technique where we give women a chance at bearing children. Also, if a woman is willing to donate her womb to another, should we as doctors question this? There can be several debates over this, but I do not wish to take part in any.

There are 22 women in the wait list for uterus transplant, and it must be noted that those who are opting for this procedure are from educated families. They know what they are doing.

As far as ethical issues are considered, why not think about the fact that motherhood is an instinct. A woman has the right to choose to have biological children. And if she has a medical hindrance, we as doctors, should do everything possible to ensure she can nurture her child in her womb. We are only making the best use of medical expertise and technology to give these women a chance to bear their own children.

MMM: How do you think governments can play a role in surgeries like this?

SP: Governments should support surgeries, especially the path-breaking ones. Maharashtra government has been immensely helpful. We have received encouragement and support from both CM Devendra Fadnavis and Medical Education Minister Girish Mahajan. They gave us the licence to perform the surgery, without which it would not have been possible. We want to thank everyone who helped us in our journey, including the Dean of Sassoon Hospital. We have had a lot of positivity from a lot of people. This has been our driving force.