Laparoscopic-assisted formation of a colon neovagina.
We report the laparoscopic formation of a colon neovagina following radical hysterectomy with subtotal colpectomy and radiotherapy in a 43-year-old woman who wished to resume normal vaginal sexual intercourse. The rectum was transected by a laparoscopic stapling device, preserving the inferior mesenteric and the superior rectal artery. By suprapubic mini-laparotomy, the rectosigmoid colon was eventerated and transected 8 cm above the staple line. Following colorectal anastomosis, the isolated bowel segment was rotated 180 degrees and placed on the right side of the anastomosis. A 12-mm trocar was introduced, transvaginally, and the isolated bowel segment was sutured to the vaginal resection margin. There were no peri- or postoperative complications. Six months after surgery, a stenotic area at the entrance to the neovagina was incised. At 12 months after primary surgery, the neovagina allowed normal sexual activity. Laparoscopically assisted formation of a colon neovagina is a surgical alternative for vaginal reconstruction that can be performed successfully even in irradiated patients.
Possover
M
M
Department of Gynecology, Friedrich Schiller University, Bachstr. 18, 07740 Jena, Germany. mpossover@bach.med.uni-jena.de
Drahonowski
J
J
Plaul
K
K
Schneider
A
A
D000328:Adult; D000714:Anastomosis, Surgical; D003106:Colon / Q000637:transplantation*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D019738:Surgically-Created Structures; D002583:Uterine Cervical Neoplasms / Q000601:surgery; D014621:Vagina / Q000601:surgery*