Gender dysphoria: laparoscopic sigmoid vaginoplasty. Another utility of indocyanine green
| Autor: | Teresa Pérez-Pérez, Eduardo Simón-Sanz, Álvaro García-Granero, Francisco J. Nohales-Alfonso, Jorge Sancho-Muriel, Blas Flor-Lorente, Vicent Primo-Romaguera, Jose Gerardo Rosciano |
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| Rok vydání: | 2021 |
| Předmět: |
Indocyanine Green
Gender dysphoria medicine.medical_specialty genetic structures medicine.medical_treatment Anastomosis Multidisciplinary team Ileostomy chemistry.chemical_compound Colon Sigmoid Humans Medicine Gender Dysphoria business.industry Gastroenterology Sigmoid colon Sigmoid function medicine.disease Surgery medicine.anatomical_structure chemistry Vagina Vaginoplasty Female Laparoscopy business Indocyanine green |
| Zdroj: | Colorectal Disease. 23:3272-3275 |
| ISSN: | 1463-1318 1462-8910 |
| DOI: | 10.1111/codi.15952 |
| Popis: | AIM Gender dysphoria is the disagreement between the gender of birth and the one with which the patient identifies. For its management it is mandatory to have a multidisciplinary team. Gender confirmation surgery with penoscrotal skin flap is the procedure of choice, and a sigmoid vaginoplasty is a feasible alternative. The new technologies and the help of indocyanine green (ICG) fluorescence can help to guarantee a correct neovagina vascularization. The objective of this paper is to present the surgical technique of laparoscopic sigmoid vaginoplasty assisted by ICG. METHODS We present two patients with gender dysphoria and a history of stricture of the penoscrotal skin flap vaginoplasty. We performed sigmoid vaginoplasty by the laparoscopic approach. We began the procedure with the mobilization and section of 30 cm of sigmoid colon, selective ligation of the vessels assisted by ICG, 180° sigmoid rotation, externalized on antiperistaltic position, construction of colovestibular anastomosis and promontory fixation. We finished the procedure with virtual ileostomy construction and drain placement. RESULTS Patients recovered satisfactorily and were discharged on the seventh day after surgery without complications. CONCLUSION Sigmoid vaginoplasty is a safe and feasible procedure. ICG has great value, contributing to the selective ligation of the vessels, allowing 180° sigmoid rotation and guaranteeing the irrigation of the neovagina. |
| Databáze: | OpenAIRE |
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