Robotic assisted hysterectomy and colpectomy as gender affirming surgery in trans men: an instructional video and perioperative considerations

TL;DR

This paper describes a robotic-assisted surgical method for trans men undergoing gender-affirming hysterectomy and colpectomy, including a video guide and outcomes from 18 patients.

Contribution

The novel use of a uterovaginal manipulator device in robotic-assisted hysterectomy and colpectomy for trans men is presented.

Findings

Robotic-assisted laparoscopic hysterectomy and colpectomy in trans men is feasible with the use of a uterovaginal manipulator device.

The procedure had a mean operating time of 175 minutes and a median hospital stay of 3 days.

Complications included two major and seven minor, highlighting the need for proper patient counseling.

Abstract

The objective of this paper is to present a method of hysterectomy and colpectomy in trans men seeking gender affirming surgery using a uterovaginal manipulator device.

Eighteen consecutive patients underwent robotic assisted laparoscopic hysterectomy and colpectomy as gender affirming surgery. The perioperative descriptive statistical data as well as complications were documented. An instructional video has been prepared and is provided as Supplementary Material.

Patients had a median age of 28 years and a mean BMI of 23.5 ± 3.8 Kg/m2. Mean operating time was 175 ± 25 min (median 180), mean blood loss was 219 ± 142 ml (median 200) and mean hospital stay was 4.6 ± 5.9 days (median 3). Two major (one compartment syndrome which required re-surgery and one bladder injury which resolved intraoperatively) and seven minor complications occurred (5 patients with urinary retention and 2 urinary tract tract infections) occurred.

Robotic assisted laparoscopic hysterectomy and colpectomy in trans men seeking gender affirming surgery is a feasible option, facilitated by the use of a uterovaginal manipulator device. Candidates for the procedure should be properly counseled in anticipation of possible complications.

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