63: Robotic assisted sigmoid vaginoplasty in an adolescent girl with vaginal agenesis

Abstract

To demonstrate the approach of a robotically assisted sigmoid vaginoplasty in an adolescent girl with vaginal agenesis. A 17 year-old girl was referred to our center for management options of vaginal agenesis. She presented to her primary OBGYN with complaints of primary amenorrhea. Examination revealed a vaginal “dimple” with normal external genitalia and secondary sexual characteristics. Her work up was notable for MRI of her pelvis showing normal appearing ovaries with absence of a vagina, cervix, and uterus. Additionally, her abdominal ultrasound revealed normal bilateral kidneys. Given her findings in addition to a normal chromosomal analysis, she was diagnosed with vaginal agenesis. During her evaluation at our center, she was counseled extensively on the surgical and non-surgical treatment options including the risks and benefits involved with each method. She opted for the robotic assisted sigmoid vaginoplasty. The procedure was successfully performed by a surgical team that included female pelvic medicine & reconstructive surgery, plastic surgery, and colorectal surgery. The procedure demonstrates the minimally invasive approach to harvesting a sigmoid colon segment for vaginoplasty. The robotic assisted sigmoidvaginoplasty is a feasible and minimally invasive technique to surgically treat vaginal agenesis.