Laparoscope-Assisted Creation of a Neovagina Using Pedicled Ileum Segment Transfer
- 446 Downloads
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.
KeywordsContinuous Renal Replacement Therapy Pelvic Cavity Transsexualism Ileal Segment Perineal Approach
Supplementary material 1 (MPG 930 kb)
Supplementary material 2 (MPG 1038 kb)
- 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
- 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
- 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.Zhao YZ, Jiang DZ, Jiang H et al (2006) Laparoscopic small intestinal flap colpopoiesis. Chin J Plast Surg (Chin) 22:339–342Google Scholar
- 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
- 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