First robotic vaginal reconstruction surgery successful

Bengaluru: Fortis Hospital, Bannerghatta Road successfully performed a complex surgery on a 23-year-old female who was diagnosed with testicular feminization syndrome at the age of 6 years. The patient had been experiencing Amenorrhea - the absence of menstrual periods since around 17 years and was found to have testes (male gonads or testicles) in her abdomen during a thorough medical evaluation.

Testicular feminization syndrome also known as androgen insensitivity syndrome (AIS) is a rare, inherited, sexual development disorder that affects approximately 1 in 10,000 people. People with AIS are genetically male, but don’t develop male external genitals because their bodies can’t respond to male sex hormones. As a result, they appear externally like normal females at birth, but have internal male reproductive organs, including testes found in the abdomen or inguinal canal. They may also have a short or closed vagina and no uterus, fallopian tubes or ovaries.

The Senior Director - Urology, Uro-Oncology, Uro-Gynaecology, Andrology, Transplant and Robotic Surgery, Fortis Hospitals, Bengaluru and Chairman - Renal Sciences Specialty Council, Fortis Hospitals, Dr Mohan Keshavamurthy said, “The patient’s body was unable to respond to male hormones, resulting in the development of female external genitalia but with internal male reproductive organs. We performed a robotic laparoscopic vaginal reconstruction using ileal loop (a small opening that allows the kidneys to drain and urine to exit the body) to create a vagina in the patient.

The procedure involved taking a small piece of tissue from the patient’s intestine to create a vaginal lining. The surgery was performed under general anaesthesia, with the use of a robotic system to improve the precision and accuracy of the procedure. The robotic system also allowed for a minimally invasive approach, resulting in reduced pain and a shorter recovery time for the patient.

‘Currently, the patient is doing well and has been prescribed life-long hormone replacement therapy. Androgen Insensitivity Syndrome (AIS) is usually detected at puberty when a girl should but does not begin to menstruate. Many of the girls with the AIS have no pubic or armpit hair. They are sterile and cannot bear children. They are at high risk for osteoporosis and so should take hormone replacement therapy,’ added Dr Mohan.

The Business Head, Fortis Hospitals, Bangalore, Akshay Oleti said, “Fortis Hospital Bannerghatta’s recent success in the treatment of testicular feminisation syndrome with robotic laparoscopic vaginal reconstruction using ileal loop is a testament to the hospital’s expertise in treating complex cases.

The use of cutting-edge technology and the expertise of our clinicians has led to the positive outcome of such a rare case, and Fortis Hospital Bannerghatta continues to lead the way in providing innovative and effective medical solutions to patients in the niche robotic urology space.”