This new surgical technique, developed in the United States, reduces surgery time and the risk of complications
The Functional Transgender Surgery Unit of the Bellvitge University Hospital has performed for the first time in Europe a gender reassignment surgery using a surgical robot. The intervention, a robotic vaginoplasty with peritoneal flap, was performed on a 30-year-old patient.
The surgery was carried out together by urological surgeons and plastic surgeons from the Transgender Unit, coordinated by Dr Anna López Ojeda.
To train in this technique, Dr Begoña Etcheverry, from the Urology Unit of the Bellvitge Hospital, spent two months at NYU Langone Hospital in New York with the team of urologist Dr Lee C. Zhao and plastic surgeon Dr Rachel Bluebond-Langner, two of the promoters and world leaders in this type of technique, with more than 600 operations performed.
The most frequently used feminising surgery is penile inversion vaginoplasty. The incorporation of robotic surgery into this technique allows the use of the peritoneal flap to ensure depth and facilitate the creation of the neovaginal canal. Using robotic arms and controls allows for more precise instrumentation, a higher-quality vision, and better access to hard-to-reach areas of the pelvic cavity.
For patients, the advantages of this new type of operation are a reduced risk of vaginal prolapse (sagging) and possible injury to the rectum during surgery, as well as a reduction in the duration of the procedure, since two surgical fields are being approached at a time. In the future, it is hoped that this type of procedure will also shorten hospital stay and improve the functional results of patients.
Dr Begoña Etcheverry states that “four years of experience with this technique in the United States have shown that it is a very safe and advantageous procedure for patients”. She also adds that “the multidisciplinary team and expert in robotic surgery at Bellvitge is ideal to start a program of this type of surgery”
The Bellvitge University Hospital has two operating theatres equipped with the Da Vinci robotic system, with which it performs around 500 robotic surgeries a year. The first robotic operating theatre was launched in 2009 (renovated in 2016 with a new state-of-the-art robot) and the second in 2019.
In addition, the Bellvitge University Hospital has created, together with the University of Barcelona and the company ABEX Excelencia Robótica, the UB - Bellvitge University Hospital Chair of Robotic Surgery ABEX, with the aim of promoting the development of training and research in this field in five surgical specialties. This is the second chair of its kind in Spain and the first one with business support.
The Urology Department, headed by Dr Francesc Vigués, has led the incorporation of this new transgender surgery technique and is one of the leading groups in Spain regarding the number and results of urological robotic interventions. It has also pioneered several robotic procedures in Catalonia, Spain and worldwide.
The Functional Transgender Surgery Unit at The Bellvitge University Hospital was launched in October 2019, after the Catalan Health Service designated this hospital as one of the three reference centres in Catalonia for the surgical care of transgender people. It is a multidisciplinary unit with recognised experience in the field of complex genital surgery, that counts on the participation of specialists from the Urology, Plastic and Reconstructive Surgery and Gynaecology services, among others. Since it was set up, it has performed up to 39 transgender surgeries.
Gender reassignment surgery offers transgender people the possibility of genital reassignment so that they can reaffirm their felt identity. It is one of the possibilities in the process of treating the emotional distress or emotional suffering that many transgender people experience due to their gender identity differs from the sex they were assigned at birth or because of sex-related physical characteristics.