An endoscopically assisted technique for construction of a neovagina

Abstract

The specific disadvantage of the commonly used Vecchietti method for reconstruction of the vagina in cases of vaginal agenesis is the need for laparotomy. We now describe a successful endoscopically assisted construction of a neovagina by a variation of the Vecchietti method. The method causes relatively little stress to the patient.

Mullerian dysgenesis: a critical review of the literature

“…Many modifications of the classic Vecchietti procedure have been described with the majority trying to perform the whole operation laparoscopically and avoid the dissection of the vesicorectal space [5,154,155]. Fedele et al [156], in 2008, reported an anatomic success of 98% within 8 days after surgery, 97% functional success, and only four bladder and two rectal injuries in 110 patients with MRKH syndrome treated with the laparoscopic version of the classic Vecchietti procedure.…”

Improvement of endoscopically assisted neovagina: new application instruments and traction device

“…The springs also have movable rollers [3] to protect the thread. The threads are run around these and then placed in the holding device slit.…”

“…The curvature of the thread guide has been optimized to enable the surgeon to apply different surgical variants [3,4,7]. This modified curvature now also facilitates the positioning of the traction device as cranially as possible while allowing the execution of a complete peritonealization.…”

“…In 1992 in the gynecological hospital of Heidelberg a new and successful endoscopically assisted creation of a neovagina [3,4] was developed by a variation of the Vecchietti's method. Since this time the laparotomy is not any more necessary for this kind of operation and the laparoscopic method presently is an established method.…”

“…It was necessary, because the usually used technique instruments [2,3,4] had some important weak points such as the complicated application of the traction device which needed a long time. Also the tightening of the threads intra-and postoperatively was complicated because of the construction of the traction device.…”