Single Port and Multiport Approaches for Robotic Vaginoplasty With the Davydov Technique.

Abstract

OBJECTIVE:

To demonstrate the feasibility, surgical technique, and initial outcomes of robotic vaginoplasty with peritoneal flap (Davydov) technique for vaginal reconstruction.

METHODS:

Following appropriate preoperative patient counseling, 11 consecutive patients underwent robotic vaginoplasty with the da Vinci (Intuitive Surgical, Sunnyvale CA) multiport Xi and single port robotic platforms. Perioperative and postoperative outcomes of interest were retrospectively collected.

RESULTS:

Between March 2019 and October 2019, a total of 11 patients have undergone robotic vaginoplasty with peritoneal flap technique at our institution-9 using the da Vinci single port platform and 2 using the da Vinci Xi platform. Reasons for vaginoplasty included primary gender-affirming genital reconstruction, vaginal stenosis after gender confirmation surgery, and vaginal hypoplasia secondary to disorders of sexual development. Mean operative time was 267.2 ± 85.9 minutes. Initial postoperative mean vaginal depth was 13.9 ± 0.5 cm. Mean estimated blood loss was 131.8 ± 92.9 mL. Mean length of stay was 5.2 ± 0.6 days and time to return of bowel function was 1.7 ± 0.9 days. Thirty-day readmission rate was 18% (N = 2/11) with 1 patient (9%) requiring surgical revision of the neovagina.

CONCLUSION:

Robotic-assisted Davydov technique is a potentially applicable, efficacious, and safe method of vaginal reconstruction in cisgender and transgender individuals.

• Authors: Omer Acar, Laurel Sofer, Ryan W Dobbs, David T Greenwald, Whitney R Halgrimson, Simone Crivellaro, Ervin Kocjancic
• Journal: Urology (Urology) Vol. 138 Pg. 166-173 (04 2020) ISSN: 1527-9995 [Electronic] United States
• PMID: 31904396 (Publication Type: Journal Article)
• Copyright: Copyright © 2020 Elsevier Inc. All rights reserved.

Topics

• Adult
• Blood Loss, Surgical (statistics & numerical data)
• Constriction, Pathologic (surgery)
• Disorders of Sex Development (surgery)
• Feasibility Studies
• Female
• Humans
• Laparoscopy (adverse effects, methods)
• Length of Stay (statistics & numerical data)
• Male
• Middle Aged
• Operative Time
• Peritoneum (transplantation)
• Plastic Surgery Procedures (methods)
• Retrospective Studies
• Robotic Surgical Procedures (adverse effects, methods)
• Sex Reassignment Surgery (adverse effects, methods)
• Surgical Flaps (adverse effects, transplantation)
• Vagina (pathology, surgery)
• Young Adult