Jasmeena Sahota

University of Warwick
United Kingdom

Abstract Title: Outcomes of Minimally Invasive Living-donor Hysterectomy for Uterine Transplantation: A Systematic Review

Biography:

Jasmeena Sahota is a penultimate-year medical student at the University of Warwick. She holds a BSc in Biomedical Sciences from the University of Liverpool and conducted this research under the supervision of Dr. Saran Shantikumar, Associate Clinical Professor in Public Health at the University of Warwick and Course Director for the Masters in Public Health. Dr. Shantikumar holds an MBChB, has specialized qualifications in public health, and an extensive publication record in epidemiology and big-data health research.

Research Interest:

Absolute uterine factor infertility (AUFI) affects a significant proportion of women of reproductive age. Uterine transplantation (UTx) offers women with AUFI the opportunity to carry a pregnancy, but exposes healthy living-donors to major surgical risk. Minimally invasive living-donor hysterectomy (LDH), including laparoscopic (LAP), robotic-assisted laparoscopic (RAL), and hybrid robotic-open approaches, has been developed to reduce donor morbidity; however, evidence on feasibility and safety remains limited. This review evaluates peri-operative donor outcomes following minimally invasive LDH for UTx. MEDLINE, Embase, and Web of Science were searched in October 2025. Studies reporting donor outcomes after minimally invasive LDH were included. Study selection, data extraction, and risk-of-bias assessment were performed independently by two reviewers. Due to heterogeneity in techniques and outcome reporting, results were narratively synthesised. Seven studies (nine reports) including 32 living-donor hysterectomies were analysed: LAP (n=4), complete RAL (n=18), and hybrid robotic-open (n=10). LAP had the shortest operative times (median 220 minutes) and lowest estimated blood loss (median 100 mL), but required simplified venous dissection and bilateral oophorectomy in all donors. RAL enabled precise deep pelvic dissection with consistently low blood loss (median 100 mL), but had prolonged operative times (median 563 minutes) and a higher rate of Clavien-Dindo IIIb complications, including ureteric injury. Hybrid approaches facilitated consistent venous procurement with low blood loss (median 125 mL) but reported the longest operative times (median 705 minutes). Overall risk of bias was high due to small, single-centre case. Minimally invasive LDH for UTx is feasible, but operative complexity and donor complications remain key concerns. Larger, multicentre studies integrating donor and recipient outcomes are needed to optimise technique, improve donor safety, and inform guideline development for UTx programmes