World Journal of Surgery

, 35:2315 | Cite as

Laparoscope-Assisted Creation of a Neovagina Using Pedicled Ileum Segment Transfer

  • Yao-Zhong ZhaoEmail author
  • Hua Jiang
  • An-Tang Liu
  • Dao-Zhen Jiang
  • Xiao-Hai Zhu
  • Ming Qiu
  • Xiang-Min Zheng
  • Zi-Hao Lin
  • Xiang-Bin Yuan
  • Jian-Lin Zhang



To present our experience of vaginal reconstruction with the use of a pedicled ileum segment and laparoscope assistance, and to analyze its complications and long-term anatomic and functional results.


The abdominal and perineal approaches were performed simultaneously with the patient in a special position. Under the guidance of laparoscopy, the target ileal segment was harvested and transposed down to the perineum through an artificial tunnel between the bladder and the rectum. A silicon vaginal tutor was introduced into the vaginal cavity and maintained all day long for 2–3 months. The complications and the anatomical and functional results were summarized and analyzed.


From February 2002 to June 2010, 82 patients underwent laparoscope-assisted total vaginal reconstruction with a pedicled ileum segment at our department. Complications developed in 16 of 82 patients, including rectum and/or bladder injury during operation, acute renal failure, delayed healing of the ileocutaneous anastomosis, introital stenosis, and partial or complete intestinal obstruction. The abdominal cutaneous scar was acceptable after the surgery. The vulva was not altered, which was especially significant for patients with congenital vaginal atresia. The neovagina was patent, soft, moist, and flexible. The mean width and depth of the neovagina at the latest postoperative visit measured 3.2 and 15 cm, respectively.


The favorable long-term anatomical and functional results demonstrate that our technique is ideal for patients with congenital vaginal atresia or patients who need secondary vaginal reconstruction. For the primary male-to-female transsexuals or hermaphrodites, it can be an alternative method for vaginal construction.


Continuous Renal Replacement Therapy Pelvic Cavity Transsexualism Ileal Segment Perineal Approach 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Supplementary material 1 (MPG 930 kb)

Supplementary material 2 (MPG 1038 kb)


  1. 1.
    Seccia A, Salgarello M, Sturla M et al (2002) Neovaginal reconstruction with the modified McIndoe technique: a review of 32 cases. Ann Plast Surg 49:379–384PubMedCrossRefGoogle Scholar
  2. 2.
    Ghanbari Z, Dahaghin M, Borna S (2006) Long-term outcomes of vaginal reconstruction with and without amnion grafts. Int J Gynaecol Obstet 92:163–164PubMedCrossRefGoogle Scholar
  3. 3.
    Wang X, Qiao Q, Burd A et al (2007) A new technique of vaginal reconstruction with the deep inferior epigastric perforator flap: a preliminary report. Plast Reconstr Surg 119:1785–1790; discussion 1791Google Scholar
  4. 4.
    Weiwei L, Zhifei L, Ang Z et al (2009) Vaginal reconstruction with the muscle-sparing vertical rectus abdominis myocutaneous flap. J Plast Reconstr Aesthet Surg 62:335–340PubMedCrossRefGoogle Scholar
  5. 5.
    El-Sayed HM, El-Lamie IK, Ibrahim AM et al (2007) Vaginal reconstruction with sigmoid colon in vaginal agenesis. Int Urogynecol J Pelvic Floor Dysfunct 18:1043–1047PubMedCrossRefGoogle Scholar
  6. 6.
    Abd El-Aziz S (2006) Vaginal reconstruction using the ileocecal segment after resection of pelvic malignancy. J Egypt Natl Cancer Inst 18:1–7Google Scholar
  7. 7.
    Maas SM, Eijsbouts QA, Hage JJ et al (1999) Laparoscopic rectosigmoid colpopoiesis: does it benefit our transsexual patients? Plast Reconstr Surg 103:518–524PubMedCrossRefGoogle Scholar
  8. 8.
    Zhao YZ, Qiu M, Jiang H et al (2002) Laparoscopic small intestinal flap for colpopoiesis. Acad J Sec Mil Med Univ 23:684–685Google Scholar
  9. 9.
    Zhao YZ, Jiang DZ, Jiang H et al (2006) Laparoscopic small intestinal flap colpopoiesis. Chin J Plast Surg (Chin) 22:339–342Google Scholar
  10. 10.
    Imparato E, Alfei A, Aspesi G et al (2007) Long-term results of sigmoid vaginoplasty in a consecutive series of 62 patients. Int Urogynecol J Pelvic Floor Dysfunct 18:1465–1469PubMedCrossRefGoogle Scholar
  11. 11.
    Fotopoulou C, Neumann U, Klapp C et al (2008) Long-term effects of neovaginal reconstruction with sigmoid loop technique on sexual function and self image in patients with gynecologic malignancies: results of a prospective study. Gynecol Oncol 111:400–406PubMedCrossRefGoogle Scholar
  12. 12.
    Liguori G, Trombetta C, Bucci S et al (2006) Laparoscopic mobilization of neovagina to assist secondary ileal vaginoplasty in male-to-female transsexuals. Urology 66:293–298; discussion 298Google Scholar
  13. 13.
    Trombetta C, Liguori G, Siracusano S et al (2005) Transverse retubularized ileal vaginoplasty: a new application of the Monti principle: preliminary report. Eur Urol 48:1018–1023PubMedCrossRefGoogle Scholar
  14. 14.
    Urbanowicz W, Starzyk J, Sulislawski J (2004) Laparoscopic vaginal reconstruction using a sigmoid colon segment: a preliminary report. J Urol 171(6 Pt 2):2632–2635Google Scholar
  15. 15.
    Schneider W, Nguyen-Thanh P, Dralle H et al (2009) Ileal J-pouch vaginoplasty: reconstruction of a physiologic vagina with an ileal J-pouch. Am J Obstet Gynecol 200:e691–e694CrossRefGoogle Scholar
  16. 16.
    Davies MC, Creighton SM (2007) Vaginoplasty. Curr Opin Urol 17:415–418PubMedCrossRefGoogle Scholar
  17. 17.
    Selvaggi G, Ceulemans P, De Cuypere G et al (2005) Gender identity disorder: general overview and surgical treatment for vaginoplasty in male-to-female transsexuals. Plast Reconstr Surg 116:135e–145ePubMedCrossRefGoogle Scholar
  18. 18.
    Parsons JK, Gearhart SL, Gearhart JP (2002) Vaginal reconstruction utilizing sigmoid colon: complications and long-term results. J Pediatr Surg 37:629–633PubMedCrossRefGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2011

Authors and Affiliations

  • Yao-Zhong Zhao
    • 1
    Email author
  • Hua Jiang
    • 1
  • An-Tang Liu
    • 1
  • Dao-Zhen Jiang
    • 2
  • Xiao-Hai Zhu
    • 1
  • Ming Qiu
    • 2
  • Xiang-Min Zheng
    • 2
  • Zi-Hao Lin
    • 1
  • Xiang-Bin Yuan
    • 1
  • Jian-Lin Zhang
    • 1
  1. 1.Department of Plastic SurgeryChangzheng Hospital, Second Military Medical UniversityShanghaiPeople’s Republic of China
  2. 2.Department of Minimally Invasive SurgeryChangzheng Hospital, Second Military Medical UniversityShanghaiPeople’s Republic of China

Personalised recommendations