Summary
Vaginal agenesis is a rare congenital disorder of female genital tract. Vaginal reconstruction
using bowel segment is usually offered last when dilatation and/or prior vaginal reconstruction
attempts using graft or flap has failed. Traditionally accomplished using open surgical
approach, we describe here our initial experience of robotic-assisted ileo-vaginoplasty.
The index patient presents to us with inadequate vaginal depth after failed buccal
mucosal graft vaginoplasty. With the patient in low lithotomy position, port placement
and docking of the robot was done. Isolation of ileal segment, closure at its proximal
end and end-to-end bowel anastomosis was accomplished successfully. However, in view
of dense adhesions the subsequent pull-down of the ileal segment into the perineum
could not be done safely. The procedure was completed using combined abdomino-perineal
open approach.
A vaginal stent (in the ileal segment) and a catheter (in the introitus) were placed
post-operatively. Post-operative recovery was uneventful.
At 2-weeks, 3 months and a subsequent 1 year follow-up Cystoscopy and examination
under anesthesia revealed an adequate vaginal depth with patient reporting successful
vaginal dilatation.
Robotic reconstruction of vagina using bowel segment in select patient, is safe and
feasible, but possible with formidable surgical experience.
Keywords
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References
- Management of vaginal agenesis.J Pediatr Adolesc Gynecol. 2012 Dec; 25: 352-357
- Mayer-Rokitansky-Küster-Hauser syndrome. A report of two cases.Ginecolog Obstet Mex. 2012 Oct; 80: 663-667
Article info
Publication history
Published online: January 25, 2021
Accepted:
January 20,
2021
Received in revised form:
December 19,
2020
Received:
November 24,
2020
Identification
Copyright
© 2021 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
