J Korean Soc Plast Reconstr Surg.  2011 May;38(3):333-337.

Vaginal Reconstruction with Laparoscopic-perineal Rectosigmoid Colpopoiesis in Mayer-Rokitansky-Kuster-Hauser Syndrome: A Case Report

• Bae SG
• Lee SY
• Cho BC
• Choi KS

Abstract

PURPOSE
Various operations have been proposed to compensate for congenital absence of the vagina using ileal or colonic interposition. These methods involve laparotomy, which shows postoperative complications such as long scar and delayed recovery. One case of neovagina reconstruction with laparoscopic rectosigmoid colpopoiesis in Mayer-Rokitansky-Kuster-Hauser syndrome is presented to avoid laparotomic complications.
METHODS
Laparoscopic surgery was performed in a 27-year-old MRKH syndrome patient. After a cruciate incision, blunt dissection through two-finger wide space was created between the bladder and the rectum. A 14-cm rectosigmoid segment vascularized by a branch of sigmoid artery was isolated by laparoscopy. The distal end was sutured with vaginal vestibule mucosa. A continuity of intestine was restored by circular end-to-end proximate curved intraluminal stapler CDH29(R) through perineal opening.
RESULTS
Total operation time was 4 hr 15 min. Normal walking and ingestion were possible within 3 days and 4 days after surgery. The hospital stay was 7 days and the patient was followed up for 6 months. The neovaginal introitus was wide enough for inserting two fingers, and there has been no narrowing of the neovagina on palpation as confirmed by vaginogram. The patient had functional self-lubricating neovagina without excessive mucous production or the need for routine dilation or unnoticeable scar.
CONCLUSION
The successful result of this laparoscopic vaginal reconstruction technique with rectosigmoid segment suggests that this technique can be considered for the option of vaginal reconstruction in girls with the MRKH syndrome.

Keyword

Laparoscopy; Vagina; Procedure; Reconstructive surgical; Rectosigmoid

MeSH Terms

Abnormalities, Multiple
Adult
Arteries
Cicatrix
Colon
Colon, Sigmoid
Eating
Fingers
Humans
Intestines
Kidney
Laparoscopy
Laparotomy
Length of Stay
Mucous Membrane
Mullerian Ducts
Palpation
Postoperative Complications
Rectum
Somites
Spine
Urinary Bladder
Uterus
Vagina
Walking
Abnormalities, Multiple
Kidney
Mullerian Ducts
Somites
Spine
Uterus
Vagina