Creation of Sigmoid Neovagina Using a Laparoscopic “NOTES”-Technique

Abstract

Study Objective: There are two main types of procedures to create a neovagina.One creates a new cavity by progressive lengthening(Frank,Vecchietti) using dilators or by surgical dissection followed by epithelisation or skin grafting.These neovaginas tend to shorten and contract and require regular dilation for longer time periods. The advantages of intestinal transplants on the other side include:adequate length, natural lubrication, no need for postoperative manipulaion, early coitus and a lack of shrinkage. We demonstrate a new, minimally invasive, completely laparoscopic technique using the vaginal dimple as access for the intestinal stapler(EEA-)anastomosis (NOTES-technique) So far we have operated 12 patients with this method.There were no complications and patients were discharged early. All patients were followed up 6 and 12 weeks after the operation.One patient needed a minor scar correction but all were satisfied with the result and there was neither excess mucus formation nor foul discharge. Study Objective: There are two main types of procedures to create a neovagina.One creates a new cavity by progressive lengthening(Frank,Vecchietti) using dilators or by surgical dissection followed by epithelisation or skin grafting.These neovaginas tend to shorten and contract and require regular dilation for longer time periods. The advantages of intestinal transplants on the other side include:adequate length, natural lubrication, no need for postoperative manipulaion, early coitus and a lack of shrinkage. We demonstrate a new, minimally invasive, completely laparoscopic technique using the vaginal dimple as access for the intestinal stapler(EEA-)anastomosis (NOTES-technique) So far we have operated 12 patients with this method.There were no complications and patients were discharged early. All patients were followed up 6 and 12 weeks after the operation.One patient needed a minor scar correction but all were satisfied with the result and there was neither excess mucus formation nor foul discharge.