Laparoscopic-assisted formation of a colon neovagina

Abstract

We report the laparoscopic formation of a colon neovagina following radical hysterectomy with subtotal colpectomy and radiotherapy in a 43-year-old woman who wished to resume normal vaginal sexual intercourse. The rectum was transected by a laparoscopic stapling device, preserving the inferior mesenteric and the superior rectal artery. By suprapubic mini-laparotomy, the rectosigmoid colon was eventerated and transected 8 cm above the staple line. Following colorectal anastomosis, the isolated bowel segment was rotated 180 degrees and placed on the right side of the anastomosis. A 12-mm trocar was introduced, transvaginally, and the isolated bowel segment was sutured to the vaginal resection margin. There were no peri- or postoperative complications. Six months after surgery, a stenotic area at the entrance to the neovagina was incised. At 12 months after primary surgery, the neovagina allowed normal sexual activity. Laparoscopically assisted formation of a colon neovagina is a surgical alternative for vaginal reconstruction that can be performed successfully even in irradiated patients.

Laparoscopy and its current role in the management of colorectal disease

“…These procedures range from the simplest laparoscopic stoma creation to complex procedures such as the one‐stage soave pull‐through operation for Hirschsprung's disease or total abdominal colectomy [8–10]. Different techniques were described [11–13], and innovative approaches were developed [7,14–17]. This development has been, in part, facilitated by advances in medical technology; the advent of mechanical endostaplers, ultrasonic dissectors, hand access devices and laparoscopic ultrasonography etc.…”

Neovagina Reconstruction Utilizing the Bladder and Urethra Following Radical Radiation Therapy

“…3 Prior studies have reported surgical difficulties associated with tissue loss, fistulas, bowel complications, and decreased blood supply. 15,16 Consequently, innovative procedures have been employed in an attempt to improve patient outcomes. 13,14 We report the status of a patient who had neovaginal reconstruction due to radiation fibrosis, ureteral obstruction, severe urinary incontinence, and dyspareunia following treatment for cervical carcinoma.…”

Methodische Entwicklung von evidenzbasierten Leitlinien am Beispiel der S3-Leitlinie „Diagnostik, Therapie und Nachsorge der Patientin mit Zervixkarzinom“

“…Allerdings konnte für Patientinnen, die mit kurativer Intention behandelt wurden, die positive Wirksamkeit psychoedukativer Maßnahmen auf die Lebensqualität nachgewiesen werden [412]. Diese Patientinnen profitierten von Informationen bezüglich alternativer Hormontherapien, Scheidenzäpfchen und Vaginaldilatatoren [413,414] [467][468][469][470]. Eine prätherapeutische (neoadjuvante) Chemotherapie [471], eine intraoperative Radiotherapie [269] respektive die Erweiterung der Operation im Sinne einer "laterally extended endopelvic resection" (LEER) kann erwogen werden, wenn das Tumorrezidiv gegen die Beckenwand vorwächst [472].…”