Our Summary

This research paper discusses a surgical procedure called “laparoscopic sigmoid vaginoplasty” for people who are experiencing gender dysphoria - a condition where a person identifies with a different gender than the one they were assigned at birth. This condition often requires a team of various health professionals to manage.

The procedure discussed in the paper is typically selected when the person has had complications with a previous procedure, such as a penoscrotal skin flap vaginoplasty, which is a common surgery for gender transition. The new procedure involves using a section of the sigmoid colon (part of the large intestine) to create a vagina (neovagina). This is done using a minimally invasive surgical procedure known as ‘laparoscopy’.

The researchers highlight the use of a special dye called indocyanine green (ICG), which helps to make sure that the new vagina is getting enough blood supply. This is important to ensure the success of the surgery and reduce complications.

The paper concludes by mentioning that two patients who underwent this procedure recovered well and were able to leave the hospital seven days after the surgery without any complications. They concluded that this procedure is safe and feasible, and that ICG plays a valuable role in the procedure.

FAQs

  1. What is “laparoscopic sigmoid vaginoplasty” and who is it for?
  2. How does the use of indocyanine green (ICG) contribute to the success of the laparoscopic sigmoid vaginoplasty procedure?
  3. What were the outcomes for the patients who underwent this surgical procedure as mentioned in the research paper?

Doctor’s Tip

A doctor may advise a patient considering vaginoplasty to thoroughly research the procedure and choose a skilled and experienced surgeon. It is important to have realistic expectations and to follow post-operative care instructions carefully to ensure a successful outcome. Additionally, discussing any concerns or questions with the healthcare team can help alleviate anxiety and ensure a smooth recovery process.

Suitable For

Overall, vaginoplasty is typically recommended for transgender individuals who are experiencing gender dysphoria and wish to undergo gender-affirming surgery to align their physical appearance with their gender identity. Patients who have had complications with previous procedures or who require a more complex surgical approach may be recommended for procedures such as laparoscopic sigmoid vaginoplasty. It is important for patients considering vaginoplasty to consult with a team of healthcare professionals, including surgeons, mental health professionals, and endocrinologists, to ensure that they are well-informed about the procedure and its potential risks and benefits.

Timeline

Before vaginoplasty:

  1. Patient experiences gender dysphoria and seeks medical help for gender transition.
  2. Patient consults with various health professionals, including a surgeon specializing in gender-affirming surgeries.
  3. Patient discusses different surgical options for vaginoplasty, including laparoscopic sigmoid vaginoplasty.
  4. Patient undergoes pre-operative evaluations and tests to determine eligibility for surgery.
  5. Patient prepares for surgery by following pre-operative instructions, such as stopping certain medications and fasting.

After vaginoplasty:

  1. Patient undergoes laparoscopic sigmoid vaginoplasty procedure, where a neovagina is created using a section of the sigmoid colon.
  2. Patient is monitored closely during and after surgery for any complications.
  3. Patient stays in the hospital for post-operative care and recovery.
  4. Patient may experience discomfort, swelling, and bruising in the surgical area.
  5. Patient is discharged from the hospital once they are stable and able to care for themselves at home.
  6. Patient follows post-operative instructions for wound care, pain management, and activity restrictions.
  7. Patient attends follow-up appointments with their surgeon to monitor healing and address any concerns.
  8. Patient undergoes physical therapy and dilation therapy to maintain the functionality and appearance of the neovagina.
  9. Patient experiences improved quality of life and satisfaction with their gender identity post-vaginoplasty.

What to Ask Your Doctor

Some questions a patient should ask their doctor about vaginoplasty include:

  1. What are the potential risks and complications associated with vaginoplasty, specifically laparoscopic sigmoid vaginoplasty?
  2. How long is the recovery period after vaginoplasty, and what can I expect during the recovery process?
  3. Will I need to follow a specific post-operative care regimen or take any medications after the surgery?
  4. How long do the results of vaginoplasty typically last, and are there any long-term effects to consider?
  5. What are the expected outcomes of vaginoplasty in terms of appearance, sensation, and function?
  6. Are there any alternative treatments or procedures that may be suitable for my specific situation?
  7. Will I need to undergo any additional surgeries or procedures in the future to maintain or enhance the results of vaginoplasty?
  8. What qualifications and experience do you have in performing vaginoplasty procedures, particularly laparoscopic sigmoid vaginoplasty?
  9. How can I prepare for vaginoplasty, both physically and mentally, before undergoing the procedure?
  10. Are there any specific lifestyle changes or precautions I should take before or after vaginoplasty to ensure the best possible outcome?

Reference

Authors: Flor-Lorente B, Rosciano JG, Pérez-Pérez T, Sancho-Muriel J, García-Granero Á, Nohales-Alfonso FJ, Primo-Romaguera V, Simón-Sanz EA. Journal: Colorectal Dis. 2021 Dec;23(12):3272-3275. doi: 10.1111/codi.15952. Epub 2021 Nov 2. PMID: 34653305