The Management of Intra-abdominal Complications Following Peritoneal Flap Vaginoplasty

Robinson, Isabel S.; Blasdel, Gaines; Bluebond-Langner, Rachel; Zhao, Lee C.

doi:10.1016/j.urology.2022.01.036

Cited by 7 publications

(6 citation statements)

References 20 publications

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“…Recurrent small bowel obstructions have resolved with bowel rest; however, incarcerated hernias especially if at the donor site of the peritoneum may require diagnostic laparoscopy and closure of the peritoneal flap site. In this series, no intraoperative complications were noted, as well as in other contemporary retrospective reviews of peri-operative complications [16,17].…”

Section: Postoperative Patient Report Outcomesmentioning

confidence: 49%

Peritoneal Vaginoplasty in Gender Diverse Patients

Haile,

Agrawal,

Fascelli

2024

Curr Obstet Gynecol Rep

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Purpose of Review To describe robotic-assisted peritoneal vaginoplasty in the genital gender affirming surgical setting and demonstrate existing surgical outcomes. Recent Findings Robotic peritoneal vaginoplasty is similar to a posterior approach to a robotic-assisted laparoscopic prostatectomy and can be done utilizing both multi-port and single port robotic platforms. Neovaginal canal depths and widths of 14 ± 0.7 cm by 3.6 ± 0.2 cm respectively can be obtained. Peritoneal flaps can also augment neovaginal depth by approximately 5 cm beyond the length of a skin graft or flap, proving advantageous in cases of genital hypoplasia or canal depth loss requiring revision. Patients typically report high sexual satisfaction following vaginoplasty. Summary The robotic peritoneal vaginoplasty as a genital gender affirming surgery offers additional neovaginal depth, with reported low complication rates, acceptable cosmesis, and satisfactory sexual function. Ongoing research in alternative grafts and revision remain to be studied.

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Section: Postoperative Patient Report Outcomesmentioning

confidence: 49%

Peritoneal Vaginoplasty in Gender Diverse Patients

Haile,

Agrawal,

Fascelli

2024

Curr Obstet Gynecol Rep

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“…In our experience, this robotically assisted vaginectomy and urethroplasty with split gracilis reinforcement technique is associated with an 8% rate of pars fixa stricture and 8% rate of pars fixa fistula. 8 This is a marked reduction in urethral complication rates, which historically have been cited to be as high as 50 to 80%. 7,29,30 In addition, we have not observed any patients with persistent vaginal remnants.…”

Section: Surgical Outcomesmentioning

confidence: 99%

“…7,29,30 In addition, we have not observed any patients with persistent vaginal remnants. 5,8 Other studies have reported high rates of persistent vaginal remnant, up to 50%. 24,30 In addition to primary vaginectomy and urethral lengthening, we have observed the benefit of the robotic approach in revision vaginectomy for vaginal remnant and/or urethral diverticulum.…”

Section: Surgical Outcomesmentioning

confidence: 99%

“…Since the senior authors' initial description of the robot-assisted peritoneal flap vaginoplasty, 4 indications for use of the robotic surgical system in gender affirming genital surgery have expanded to include revision vaginoplasty as well as primary and secondary vaginectomy. [5][6][7][8] In this article, the authors describe their experience and review their outcomes data applying robotic techniques to a range of gender affirming genital surgeries.…”

mentioning

confidence: 99%

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Robotics in Gender Affirming Surgery: Current Applications and Future Directions

2023

Self Cite

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Genital surgery for the treatment of gender dysphoria has undergone significant evolution since its inception in the first half of the 20th century. Robotic approaches to the pelvis allow for improved visualization and reduced abdominal wall morbidity, making the robotic surgical system a very useful tool in the gender affirming genital surgeon's armamentarium. In penile inversion vaginoplasty, robotically harvested peritoneal flaps can be used to augment the vaginal canal, thereby leading to improved vaginal depth, as well as improve operative efficiency by facilitating a two-surgeon approach. In transgender men, the robotic approach to vaginectomy assists with visualization to confirm complete obliteration of the vaginal canal. Robotic surgery will play a central role in the continued evolution of the field of gender affirming surgery.

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“…Peritoneal flaps can also be used in primary or revision vaginoplasty. Though this requires violation of the peritoneal cavity and carries with it all associated risks as described above, it conceals the graft donor site, has a lower possibility of rectal injury and avoids the issue of neovaginal hair growth/need for hair removal (14). This approach also requires a trained robotic surgeon's assistance and is not appropriate for patients with extensive histories of abdominal surgery.…”

mentioning

confidence: 99%