Laparoscopic Vaginoplasty Using a Sigmoid Graft Through the Umbilical Single-Incision Hybrid Transperineal Approach: Our Initial Experience

Li, Suolin; Sun, Chuanyu; Shu, Bin; Li, Meng; Liu, Lin

doi:10.1089/lap.2013.0158

Cited by 11 publications

(6 citation statements)

References 13 publications

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“…Previous reports of LSV showed that to retract the descending colon either enlargement of the port incision, minilaparatomy, including gasless laparoscopy, or one port technique be performed [3,[11][12][13]. Abdominal wall incisions are associated with a risk of infection, herniation, pain and scarring [3,4]. Since vaginoplasty requires creation of a perineal tunnel we used it to retract the descending colon and avoid an unnecessary additional incision to the abdominal wall.…”

Section: Discussionmentioning

confidence: 99%

“…One of the disadvantages of LSV is enlargement of the portal incision or minilaparotomy performed to retract the descending colon through the abdominal wall for the suture of an anvil of the circular stapler before restoration of the continuity of the intestinal tract. Abdominal wall incisions are associated with a risk of infection, herniation, pain and scar formation [3,4]. To avoid this, we describe a novel perineal approach technique.…”

Section: Introductionmentioning

confidence: 99%

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Minilaparatomy is avoidable during laparoscopic sigmoid vaginoplasty: first experience

2020

Clinical and Experimental Obstetrics & Gynecology

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Laparoscopic sigmoid vaginoplasty is a minimally invasive procedure performed in selected Mayer-Rokitansky-Kuster-Hauser syndrome patients and in other conditions when creation of a vagina is indicated. Creation of a colorectal anastomosis is one of the Laparoscopic sigmoid vaginoplasty steps. The biggest disadvantage of it is the enlargement of the portal incision resulting in minilaparotomy to retract the descending colon through the abdominal wall which could lead to postoperative complications. In this report we present a novel perineal approach technique to retract the descending colon for the suture of an anvil in Laparoscopic sigmoid vaginoplasty. Unnecessary enlargement of the port incision or minilaparatomy can be avoided if using this particular technique. A perineal approach technique can be one of the options in Laparoscopic sigmoid vaginoplasty. However, larger numbers of cases are necessary to confirm its benefits.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Minilaparatomy is avoidable during laparoscopic sigmoid vaginoplasty: first experience

2020

Clinical and Experimental Obstetrics & Gynecology

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“…Ostrzenski established a classification for a wide vagina from category A to D based on the presence/absence of columnar rugae and site-specific defects [6] ( Table 3). Vaginoplasty is mostly performed for patients with congenital vaginal deformities, women with a dysfunctional vagina, women with disorders of sex development, male-to-female transgender women in the medical literature [7][8][9][10][11][12][13], peritoneal vaginoplasty, intestinal vaginoplasty, and vaginoplasty with autologous buccal micromucosa [14][15][16][17][18][19]. In our case series, we include patients without any noticeable congenital deformity who seek improved sexual function and they do not require such an invasive surgical treatment for the correction of their vagina.…”

Section: Discussionmentioning

confidence: 99%

Vaginal Rejuvenation with Gore-Mycromesh

Park

Whang

2015

Aesth Plast Surg

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Recently, we introduced functional vaginal rejuvenation with elastic silicone threads. However, some patients with specific indications need other biocompatible materials for rejuvenation of the vagina. Gore-Mycromesh is one of the most commonly used materials in plastic and reconstructive surgical fields and it is composed of expanded poly-tetrafluroethylene. In this study, we introduced our clinical experience with static vaginal rejuvenation using Gore-Mycromesh to specifically assess the overall patient satisfaction (Female Sexual Function Index, FSFI). This study included 50 patients who underwent vaginal rejuvenation with a Gore-Mycromesh between 2010 and 2012. After marking two incisions at the inner side of the vaginal inlet and posterior wall, respectively, we performed submucosal dissection at the posterior vaginal wall and then grafted and secured a Gore-Mycromesh to the dissected area (muscle/fascia). Overall the FSFI improved as time progressed up to a year postoperatively. This is especially prominent in the FSFI satisfaction subscore. All but eight patients (42/50, 84 %) were "very satisfied (5)" or "satisfied (4)" with the outcomes after the vaginal rejuvenation. The overall complication rate was 8 %. Based on our clinical experience with the 50 cases, we think that vaginal rejuvenation with Gore-Mycromesh significantly improved postoperative outcomes, resulting in improved sexual function with a focus on improving the FSFI satisfaction subscore in mid-term follow-up. Elderly patients experience better outcomes using gore mycromesh rather than silicone thread because we can plicate the vaginal posterior wall with senile changes simultaneously using an open technique. However, further studies would be warranted for better positioning and adherence of grafted implants to surrounding tissue and for increasing the tightening effect of the implant and its sufficient longevity.

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“…The main objective of creating neovagina is to create a canal with an appropriate length, diameter, and axis and normal lubrication for a desirable sexual intercourse [7,8]. Using rectosigmoid to make neovagina is among the new methods of creating neovagina [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Successful Laparoscopic Sigmoid Transposition for Cervicovaginal Agenesis in Presence of Functional Uterus; a Case Series

Alborzi

Najarkolaee

Askary

et al. 2021

Preprint

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Background This study has been designed to investigate the long-term outcomes of laparascopic sigmoid cervicovaginoplasty in patients with congenital cervicovaginal atresia with a functional uterus and stepwise description of surgery. Methods Seven patients with cervicovaginal atresia with a functional uterus, underwent laparoscopic sigmoid cervicovaginoplasty surgery, between 2016 and 2020. All subjects underwent a successful surgery with no major complications. Mean follow-up duration was 25.9 months (2-48 months). All the patients had regular menstrual cycles. The average length of vagina was 8.9 cm (7.6-10.5 cm). In one patient, proximal stenosis of neovagina was observed 12 months after surgery. Results The mean age and BMI of the patients were 18y (12-27y) and 19.7 (17.6-22.4). The average time period between the initiation of disease symptoms and the operation was 52.28 months (2-156 months). We had no significant post-operative short term complication. We did not perform hysterectomy in our patients either at the time of first surgery or as a result of a complication. None of our patients complained of signs of low anterior resection syndrome. Two subjects had sexual activities without dyspareunia, post coital bleeding, or malodor vaginal discharge. Conclusion Sigmoid cervicovaginoplasty is a safe and effective procedure with satisfactory long term outcomes. This surgery eliminates the psychological burden of hysterectomy in these patients. Through preserving the uterus, patients may have a chance of possible future pregnancy if abdominal cerclage is performed.

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Laparoscopic Vaginoplasty Using a Sigmoid Graft Through the Umbilical Single-Incision Hybrid Transperineal Approach: Our Initial Experience

Abstract: Transumbilical single-incision hybrid transperineal laparoscopic sigmoid vaginoplasty offers a feasible scarless approach for females with MRKH syndrome. The favorable cosmetic results would favor use of this type of vaginoplasty as an alternative to the conventional laparoscopic approach.

Cited by 11 publications

References 13 publications

Minilaparatomy is avoidable during laparoscopic sigmoid vaginoplasty: first experience

Minilaparatomy is avoidable during laparoscopic sigmoid vaginoplasty: first experience

Vaginal Rejuvenation with Gore-Mycromesh

Successful Laparoscopic Sigmoid Transposition for Cervicovaginal Agenesis in Presence of Functional Uterus; a Case Series

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