Robot-Assisted Surgery
This operation is a gynaecological combination of the removal of the vagina, uterus and/or ovaries. The name of the operation is due to the fact that it is usually carried out with the assistance of robot technology. The operation is done under anaesthesia.
What is involved in a robot-assisted surgery?
In this technique, the gynaecologist makes a couple of incisions in the abdominal wall.
The laparoscope is introduced into the abdomen through an incision below the navel.
The instruments required for removal of the organs are introduced through the other incisions.
The uterus and ovaries are separated from the surrounding tissue.
The vagina wall is separated from the surrounding tissue.
At the end of the operation, the uterus and vagina wall are removed via the vagina, and the ovaries may remain.
The vagina is closed.
You can return home one or two days after the operation.
What are my arguments for and against robot-assisted surgery?
Arguments are broken down into five categories: treatment and result, quality of life, social environment, sexuality, and belief.
Treatment and Result
Arguments For
By undergoing the operation, I will suffer from fewer gynaecological discomforts, complaints or diseases.
The chance of gynaecological problems will decrease after this operation as I will have fewer female organs. I will no longer run the risk of cancer or other diseases in the organs that I have had removed.
Robot-assisted surgery means that I will have less chance of experiencing complications.
If I have my vagina, ovaries and uterus simultaneously removed through robot-assisted surgery, I will have less chance of experiencing complications than if I have the vagina removed in a separate operation.
This operation is necessary for follow-up operations.
I want to undergo this operation because I want a penis with urethra extension afterwards.
Arguments Against
The consequences of the operation are irreversible.
The operation is irreversible; if I have regrets, I cannot go back. I will become infertile if I do not take fertility preservation steps.
There is always the chance of complications with surgery.
I risk damage to my intestines, bladder and urinary tract.
I’m still unsure about which operation(s) I wish to undergo.
I’m still uncertain about the follow-up process, so I want to keep my uterus and vagina for the time being.
Quality of Life
Arguments For
I will no longer suffer from female issues.
I can no longer be troubled by the influence of female hormones.
A new hormone balance will emerge after the operation, which can bring greater calmness.
I will no longer need to participate in the population screening for cervical cancer.
I will no longer need contraception.
I am relieved that I will no longer have a uterus and will no longer be able to have children.
Multiple separate operations will be too drastic for me.
I feel that undergoing the gynaecological operations separately would be too physically and psychologically demanding for me.
Arguments Against
I do not need this surgery in order to be a man.
I do not need to undergo this surgery in order to register as a man.There is always the chance of complications with surgery.
After the operation, I will have to take hormones for the rest of my life.
I will be dependent on hormones because I will no longer have hormone-producing organs in my body.
After the operation I will experience pain and possibly side-effects.
I am not looking forward to post-operative pain, such as in my abdomen.
The physical burden of abdominal surgery is too great for me.
I think the operation is undesirable.
I want to undergo as few operations as possible.
I want to retain my female hormones.
Social Environment
Arguments For
My social environment will be able to see me as I am.
It will be positive for my social network if my external appearance matches my experienced identity.
Arguments Against
By not undergoing surgery, I will accommodate the wishes of my partner and parents
My partner wants to have children, and wants me to bear the children.
My parents are afraid that I am making a choice too soon.
My parents want their genetic material to be passed on, and I want to comply with that.
Sexuality
Arguments For
The operation will enable me to feel more like a man.
I will feel more like a man as I will no longer have female sexual organs.
I will no longer have any sexual feelings from my uterus.
My genitals have functions that align with my sexual needs.
I will no longer be able to be vaginally penetrated.
Arguments Against
After the operation, my genitalia will no longer align with my sexual needs.
I do not want my sexual feeling to change after the operation.
I would like to retain the possibility of vaginal penetration, and these operations make that impossible.
Belief
Arguments For
Female genitals do not match who I am.
A vagina, uterus and/or ovaries are not in harmony with my existence as a man, both physically and psychologically.
Arguments Against
The operations are not in harmony with my beliefs.
Having a uterus, ovaries and/or a vagina does not make me feel less like a man.