An emerging surgical technique is offering new hope to people who face infertility after treatment for bowel or rectal cancer. Radiotherapy and chemotherapy that target pelvic tumors can severely damage the uterus and ovaries, leaving many patients unable to carry a pregnancy even if they freeze eggs beforehand. To avoid this collateral damage, surgeons are now temporarily moving the uterus, fallopian tubes, and ovaries from the pelvis to the upper abdomen, stitching them to the abdominal wall so they sit below the ribs during cancer treatment and can later be returned to their original position.
A team in Switzerland recently reported the birth of a baby boy, Lucien, after his mother underwent this procedure, which was originally pioneered in Brazil by gynecologic oncologist Reitan Ribeiro. Lucien is the fifth baby to be born after the surgery and the first in Europe, according to Daniela Huber, the gyno-oncologist who performed the operation, and since then at least three others have been born, including a sixth birth announced in Israel and another two reported by Ribeiro. Huber’s patient was 28 years old when a four-centimeter tumor was found in her rectum, and she faced a treatment plan involving multiple medications and radiotherapy that would likely have destroyed her ability to carry a pregnancy, in a country where surrogacy is illegal.
Inspired by Ribeiro’s first published case report in 2017 describing a 26-year-old with a rectal tumor, Huber offered the experimental relocation surgery before cancer treatment began. The operation, which she describes as a delicate but not excessively difficult dissection, took two to three hours, with the organs stitched to the abdominal wall and the stitches removed via small incisions around a week later once scar tissue had fixed them in place. The patient recovered for two weeks before starting treatment, and within months her tumor had shrunk so much it was no longer visible on scans. Surgeons then removed the affected colon segment and returned the uterus, tubes, and ovaries to the pelvis. Around eight months later she stopped contraception, conceived without IVF, and despite growth concerns around seven months that may have related to placental blood supply, delivered a healthy baby. Ribeiro says he has performed the surgery 16 times and estimates around 40 procedures worldwide, but he and Huber stress that the approach remains experimental, carries risks including organ damage and possible cancer spread, and still requires more data to standardize and understand long-term outcomes.
