Refinement of recto-sigmoid colon vaginoplasty using a three-dimensional laparoscopic technique

Abstract

To investigate the feasibility, safety, and outcomes of three-dimensional (3D) laparoscopic vaginoplasty with a rectosigmoid colon flap for vaginal reconstruction. Following appropriate preoperative patient counseling, 17 consecutive patients underwent vaginoplasty using a 3D laparoscopic system. Perioperative and postoperative outcomes were retrospectively evaluated. Between September 2016 and February 2020, 17 patients underwent 3D laparoscopic vaginoplasty with a rectosigmoid colon flap. Of them, 15 (88%) were transgender female patients, and 2 (12%) were cisgender female patients with congenital deformities. Among the 15 transgender patients, 12 (80%) underwent de novo surgeries and 3 (20%) underwent re-do surgeries. The mean age at the time of operation was 33.0 years, and the mean total operation time was 529 ± 128 minutes. The initial intraoperative mean vaginal depth was 15.2 ± 1.3 cm, and the 30-day readmission rate was 5.9% (1/17 cases). The mean follow-up duration was 24.8 months. Perioperative and postoperative outcomes suggest that 3D laparoscopic rectosigmoid colon vaginoplasty is a potentially acceptable, effective, and safe method for vaginal reconstruction.

The Effect of Obesity on Vaginoplasty Outcomes

“…Although PIV remains the most commonly used approach, robotic peritoneal and intestinal techniques have demonstrated promising outcomes while offering the advantage of tissue capable of mucosal secretion, which has been suggested to facilitate wound healing and sexual intercourse without postoperative shrinkage. 43 These 2 techniques may thus be of particular advantage within patients with obesity to optimize wound healing and functional outcomes, as reflected by our results. In addition, the robotic approach allows for more precise tissue manipulation, minimized tissue damage, and enhanced visualization.…”

“…Our multiple logistic regression model revealed that receipt of robotic peritoneal or robotic intestinal vaginoplasty procedures was associated with lower odds of developing delayed wound healing ( P < 0.001 and P = 0.011, respectively) across the study population. Although PIV remains the most commonly used approach, robotic peritoneal and intestinal techniques have demonstrated promising outcomes while offering the advantage of tissue capable of mucosal secretion, which has been suggested to facilitate wound healing and sexual intercourse without postoperative shrinkage 43 . These 2 techniques may thus be of particular advantage within patients with obesity to optimize wound healing and functional outcomes, as reflected by our results.…”

3D laparoscopic-assisted vs open gastrectomy for carcinoma in the remnant stomach: A retrospective cohort study

“…An outstanding advantage of laparoscopic surgery is that the establishment of carbon dioxide pneumoperitoneum can make the connective tissue space appear clearly and make it possible to identify the correct dissection layer[ 22 ]. In addition, 3D laparoscopy can overcome the disadvantages of traditional laparoscopy, such as lack of sense of space and distance, presenting a stereoscopic vision closer to open surgery[ 23 ]. However, compared with open surgery, the enlarged surgical field of 3D laparoscopy shows the anatomical structure more clearly, which is more conducive to delicate operations, making it easier to find the correct anatomical level, resulting in less surgical bleeding and adverse consequences.…”