In the Journals

Laparoscopic intestinal revision vaginoplasty presents certain advantages over full-thickness skin graft revision

Laparoscopic intestinal revision vaginoplasty showed a moderately higher success rate in reconstruction over perineal full-thickness skin graft revision, depending on patient goals, according to a review published in Plastic and Reconstructive Surgery.

Wouter B. Van der Sluis, MD, PhD, and colleagues, performed a retrospective chart review of all patients who underwent secondary vaginoplasty at their center between 1995 and 2015. Patients included 50 transgender women and three biological women, of which there were 21 laparoscopic intestinal revisions and 32 perineal full-thickness skin graft procedures. The groups did not differ demographically.

Results of the review found that the laparoscopic intestinal revision group achieved adequate neovaginal depth (15.9 ± 1.4 cm) for penetrative sexual intercourse in 90% of cases compared to 80% in the perineal full-thickness skin graft group (12.5 ± 2.8 cm; P < .01). Additionally, the rate of intraoperative rectal perforations occurred only two times (10%) in the intestinal group compared with six perforations (19%; P = .46) in the full-thickness skin graft group.

Laparoscopic intestinal revision, however, is more invasive and has a longer operation time (191 ± 45 minutes) compared to the skin graft group (130 ± 35 minutes; P = .01).

“Because of our growing laparoscopic experience in intestinal vaginoplasties and the high number of rectal perforations during full-thickness skin graft revision vaginoplasty, laparoscopic intestinal revision vaginoplasty is now chosen over perineal full-thickness skin graft vaginoplasty in our center,” the authors wrote.

In contrast, however, due to the length of operation time which can take as long as primary vaginoplasty, the researchers believe that “intestinal vaginoplasty is not indicated for patients who merely wish a feminine genital appearance and do not desire penile neovaginal penetration. Furthermore, both the plastic surgeon and the laparoscopic gastrointestinal surgeon should assess the surgical eligibility.” – by Talitha Bennett

Disclosure: The researchers report no relevant financial disclosures.

Laparoscopic intestinal revision vaginoplasty showed a moderately higher success rate in reconstruction over perineal full-thickness skin graft revision, depending on patient goals, according to a review published in Plastic and Reconstructive Surgery.

Wouter B. Van der Sluis, MD, PhD, and colleagues, performed a retrospective chart review of all patients who underwent secondary vaginoplasty at their center between 1995 and 2015. Patients included 50 transgender women and three biological women, of which there were 21 laparoscopic intestinal revisions and 32 perineal full-thickness skin graft procedures. The groups did not differ demographically.

Results of the review found that the laparoscopic intestinal revision group achieved adequate neovaginal depth (15.9 ± 1.4 cm) for penetrative sexual intercourse in 90% of cases compared to 80% in the perineal full-thickness skin graft group (12.5 ± 2.8 cm; P < .01). Additionally, the rate of intraoperative rectal perforations occurred only two times (10%) in the intestinal group compared with six perforations (19%; P = .46) in the full-thickness skin graft group.

Laparoscopic intestinal revision, however, is more invasive and has a longer operation time (191 ± 45 minutes) compared to the skin graft group (130 ± 35 minutes; P = .01).

“Because of our growing laparoscopic experience in intestinal vaginoplasties and the high number of rectal perforations during full-thickness skin graft revision vaginoplasty, laparoscopic intestinal revision vaginoplasty is now chosen over perineal full-thickness skin graft vaginoplasty in our center,” the authors wrote.

In contrast, however, due to the length of operation time which can take as long as primary vaginoplasty, the researchers believe that “intestinal vaginoplasty is not indicated for patients who merely wish a feminine genital appearance and do not desire penile neovaginal penetration. Furthermore, both the plastic surgeon and the laparoscopic gastrointestinal surgeon should assess the surgical eligibility.” – by Talitha Bennett

Disclosure: The researchers report no relevant financial disclosures.