Laparoscopic-assisted formation of a colon neovagina

Abstract

We report the laparoscopic formation of a colon neovagina following radical hysterectomy with subtotal colpectomy and radiotherapy in a 43-year-old woman who wished to resume normal vaginal sexual intercourse. The rectum was transected by a laparoscopic stapling device, preserving the inferior mesenteric and the superior rectal artery. By suprapubic mini-laparotomy, the rectosigmoid colon was eventerated and transected 8 cm above the staple line. Following colorectal anastomosis, the isolated bowel segment was rotated 180° and placed on the right side of the anastomosis. A 12-mm trocar was introduced, transvaginally, and the isolated bowel segment was sutured to the vaginal resection margin. There were no peri- or postoperative complications. Six months after surgery, a stenotic area at the entrance to the neovagina was incised. At 12 months after primary surgery, the neovagina allowed normal sexual activity. Laparoscopically assisted formation of a colon neovagina is a surgical alternative for vaginal reconstruction that can be performed successfully even in irradiated patients.