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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
Article

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

Keywords

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)

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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

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