Livestream

BEST VIDEO AWARD: Gender-affirming robotic-assisted laparoscopic vaginectomy

Wednesday, October 4, 2023

3:55 PM – 4:05 PM US PST

Location: Oregon Ballroom

Video Presenter(s)

Kristin M. Jacobs, MD (she/her/hers)

Assistant Professor
Rush University Medical Center
Chicago, Illinois, United States

Co-Author(s)

SC

Sara Chitlik (she/her/hers)

Medical student
Rush University
Chicago, Illinois, United States
LS

Loren Schechter, MD

Professor
Rush University Medical Center
Chicago, Illinois, United States
BW

Brielle Weinstein, MD

Clinical Instructor
Rush University Medical Center
Chicago, Illinois, United States
MO

Michele O'Shea, MD, MPH

Assistant Professor
Rush University Medical Center
Chicago, Illinois, United States

Disclosure(s):

Kristin M. Jacobs, MD: No financial relationships to disclose

Sara Chitlik: No financial relationships to disclose

Loren Schechter, MD: WPATH: Board Member (Ongoing)

Brielle Weinstein, MD: No financial relationships to disclose

Michele O'Shea, MD, MPH: GE Women's Health US: Consultant/Advisory Board (Terminated, June 30, 2022)

Objectives: To demonstrate the key steps to successful completion of a robotic-assisted laparoscopic gender-affirming vaginectomy.

Methods: A robotic-assisted laparoscopic approach was employed for enhanced visualization of dissection planes and surrounding structures including the bladder and ureters.

Clinical Relevance: A robotic-assisted laparoscopic approach can be safely utilized to perform gender-affirming vaginectomy concomitantly with a laparoscopic hysterectomy and bilateral salpingo-oophorectomy. However, there is a paucity of literature outlining the key steps to safe performance this approach to the vaginectomy. The laparoscopic approach can aid in visualization of relevant anatomy while minimizing blood loss and operative time, and can be performed with concomitant procedures such as metoidoplasty or staged phalloplasty. Key points include preoperative planning and marking of the anticipated extent of the vaginal epithelial dissection, adequate protection of surrounding structures during the upper vaginectomy, and taking full advantage of the magnification of the robotic platform to ensure thin dissection of the vaginal epithelium off of the underlying muscularis.