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Obstetrics & Gynecology 1999;93:446-448
© 1999 by The American College of Obstetricians and Gynecologists
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INSTRUMENTS & METHODS

ULTRASOUND-ASSISTED LAPAROSCOPIC CREATION OF A NEOVAGINA BY MODIFICATION OF VECCHIETTI’S OPERATION

Pierre-Ludovic Giacalone, MD, Franançois Laffargue, MD, Jean-Michel Faure, MD and Françoise Deschamps, MD

From the Department of Obstetrics and Gynecology, Hôpital Arnaud de Villeneuve, Montpellier, France.

Address reprint requests to: Pierre-Ludovic Giacalone, MD, Department of Obstetrics and Gynecology, Hôpital Arnaud de Villeneuve, 371 rue du Doyen Gaston Giraud, 34295 Montepellier Cedex 5, France

Background: In performing Vecchietti’s operation laparoscopically, it is important to ensure bladder and rectum integrity. We report new techniques of ultrasonography and suture retrieval that simplify and improve the ease and speed of this operation.

Technique: The pneumoperitoneum is emptied and the bladder filled with 200 mL of sterile water. The ultrasound probe is placed on the suprapubic wall for a sagittal image. The needle progresses medially through the vesicorectal space, with ultrasound guidance, and its emergence into the pelvis is controlled with laparoscopy. The nylon sutures carrying the dilation ball are threaded through the needle and brought back through the abdominal wall.

Experience: Seven patients with vaginal aplasia had this procedure. There were no complications, and the mean operative time was 43 minutes (range 35–55). Mean vaginal length was 7 cm (range 6–10). Four women defined sexual intercourse as very satisfying and two as moderately satisfying.

Conclusion: This original technique was used for easy, safe, and rapid creation of neovaginas.






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