By Dr. Reju Joseph Thomas at WALS 2025

Minimal Access Surgery (MAS) has revolutionized the field of surgical intervention, offering improved outcomes, reduced recovery times, and enhanced precision. At the World Association of Laparoscopic Surgeons (WALS) 2025 conference, Dr. Reju Joseph Thomas presented groundbreaking advancements in MAS for Disorders of Sexual Differentiation (DSD), a complex group of conditions affecting genital and reproductive development. His presentation highlighted the role of minimally invasive techniques in improving surgical outcomes for patients with DSD, emphasizing innovation, patient safety, and long-term benefits.

Understanding Disorders of Sexual Differentiation

DSD encompasses congenital conditions in which chromosomal, gonadal, or anatomical sex development is atypical. These conditions may present with ambiguous genitalia, atypical hormone production, or reproductive organ abnormalities. Traditionally, the management of DSD involved open surgeries that carried risks of scarring, longer recovery, and psychological stress. However, with the advent of MAS, these challenges are being mitigated through laparoscopic and robotic-assisted techniques.

Advancements in Minimal Access Surgery for DSD

Dr. Reju Joseph Thomas, a renowned expert in laparoscopic surgery, showcased how MAS is transforming the surgical management of DSD. Key advancements discussed in his presentation at WALS 2025 included:

1. Laparoscopic Gonadectomy – For patients with conditions like Androgen Insensitivity Syndrome (AIS), laparoscopic removal of undescended or dysgenic gonads reduces cancer risk while minimizing surgical trauma.
2. Robotic-Assisted Genitoplasty – Using robotic platforms, surgeons achieve greater precision in reconstructing genital structures while preserving nerve function and aesthetic outcomes.
3. Endoscopic Vaginal and Urogenital Reconstruction – MAS enables the creation or modification of vaginal structures in cases like Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome with minimal scarring.
4. Hormone-Guided Laparoscopic Procedures – Advanced imaging and hormonal guidance optimize decision-making in gonadal preservation or removal.

Benefits of Minimal Access Surgery in DSD

Dr. Thomas emphasized several advantages of MAS in DSD management:

- Reduced Trauma and Scarring – Smaller incisions lead to less postoperative pain and better cosmetic results.
- Faster Recovery – Shorter hospital stays and quicker return to normal activities improve patient well-being.
- Improved Precision and Outcomes – Robotic-assisted surgery enhances dexterity and accuracy, leading to better functional and aesthetic results.
- Enhanced Psychological Comfort – Minimally invasive approaches reduce patient anxiety and long-term psychological distress.

Future Perspectives

Dr. Thomas concluded by discussing the future of MAS in DSD, highlighting ongoing research in tissue engineering, regenerative medicine, and artificial intelligence-driven surgical planning. He emphasized the need for interdisciplinary collaboration between endocrinologists, urologists, gynecologists, and psychologists to provide holistic care.

Conclusion

Dr. Reju Joseph Thomas’s presentation at WALS 2025 underscored the transformative potential of Minimal Access Surgery in DSD management. By integrating cutting-edge technology with patient-centered care, MAS is not only improving surgical outcomes but also enhancing the quality of life for individuals with DSD. As advancements continue, MAS will remain a cornerstone of modern surgical interventions, offering hope and improved care for patients worldwide.