Resection of Longitudinal Vaginal Septum Using a Surgical Stapler

Abstract

Background: A longitudinal vaginal septum is a rare congenital anomaly that can cause dyspareunia, difficulty with tampon insertion, persistent vaginal bleeding, and dysmenorrhea. Various surgical techniques have been described. Case: We present the case of a 14-year-old girl with obesity and diabetes mellitus with uterine didelphys and double vagina with a longitudinal vaginal septum. The patient presented with dysmenorrhea. Resection of the longitudinal vaginal septum using a GIA and EndoGIA (Medtronic, Inc, Doral Fl) stapler device was performed. Summary and Conclusion: We introduce a safe and effective technique for resecting a longitudinal vaginal septum using stapler technology. This technique eliminates the potential risk of thermal injury to nearby structures from currently described methods.

Longitudinal vaginal septum in a child: Early endoscopic resection using resectoscope

“…This technique although safe in most of the cases require meticulous dissection and hemostasis to avoid any rectal or bladder injury. To simplify, various other techniques for LVS excision has been used like bipolar forceps, ligasure, harmonic scalpel and surgical stapler, which also required reinforcement sutures [6]. Hysteroscopic ablation in adult females has also gained popularity and all these techniques have been reported to have excellent results [7].…”

Case report: Hydrometrocolpos conditioning recurrent urinary tract infections

“…Then there's electroresection, which is probably used most frequently nowadays. Finally, there are many innovative methods using different instruments described such as laparoscopic long bipolar forceps, harmonic scalpel, LigaSure (Medtronic Inc., Doral, FL), GIA, and Endo GIA device (11)(12)(13)(14). In critical cases, with the development of acute kidney failure, bladder injury, urinary leakage into the abdominal cavity, or other abdominal complications, laparotomy is recommended (15).…”

LigaSure for Management of Obstructed Hemivagina with Ipsilateral Renal Anomaly (OHVIRA) Syndrome

“…Mullerian duct anomalies occur in approximately 5.5% of uterus-possessing people in the general population, with Obstructed Hemivagina with Ipsilateral Renal Anomaly (OHVIRA) syndrome accounting for 0.16-10% of these anomalies [1,2]. patient's benign abdomen and largely unremarkable appendiceal findings on imaging.…”

“…Recent case reports mostly describe minimally invasive surgical approaches involving either single-stage or two-stage vaginoplasties, with subsequent laparoscopy mostly falling out of favor (unless indicated for other reasons) [3][4][5]. Hematocolpos drainage and vaginal septum resection have been described using a variety of methods including sharp dissection followed by marsupialization of the septum edges, unipolar needle electrodes, spinal needle aspiration, Seldinger technique, aspiration via suprapubic catheter, hysteroscopic resectoscopes, surgical staplers, bipolar energy devices, and even hemihysterectomy with vaginectomy in rare cases of cervical atresia [1][2][3][4][5]7,8]. In this case, LigaSure was used in a single-stage procedure for vaginal septum resection in OHVIRA syndrome.…”