Research Information System
INDIAN JOURNAL OF SURGERY, 2025 (SCI-Expanded)
This study aims to present the surgical technique and outcomes of laparoscopic sigmoid colon vaginoplasty in cisgender women with congenital vaginal absence and transgender individuals. Laparoscopic sigmoid vaginoplasty is a preferred option for vaginal reconstruction in these patients due to its ability to provide adequate depth, natural lubrication, and low rates of shrinkage. A retrospective analysis was conducted on 35 patients who underwent laparoscopic sigmoid colon vaginoplasty between July 2016 and December 2023. Patient demographics, surgical details, intraoperative and postoperative complications, and satisfaction levels were recorded. The mean age of the patients was 32.3 years, with 92% identifying as transgender individuals and 66% undergoing revision surgery. After an average follow-up of 49.9 months, the overall satisfaction percentage among patients was 82.34%. Among the cohort, 22 patients with the potential for a short sigmoid colon flap were treated using the end-to-side anastomosis technique, while the remaining 13 patients underwent the side-to-side anastomosis technique. Postoperative complications were observed in 11% of cases. Additionally, a higher body mass index was significantly associated with longer surgical durations, increased complication rates, and lower patient satisfaction (p < 0.05). Laparoscopic sigmoid colonic vaginoplasty provides reliable results with minimal shrinkage and natural lubrication. The end-to-side technique was useful for shorter mesenteries, while side-to-side anastomosis improved cosmetic outcomes with fewer incisions. Preoperative weight management and careful technique selection are crucial for improving patient outcomes. Larger multi-center studies are needed to confirm these findings.