Peritoneal Vaginoplasty in Gender Diverse Patients

To describe robotic-assisted peritoneal vaginoplasty in the genital gender affirming surgical setting and demonstrate existing surgical outcomes.

Robotic peritoneal vaginoplasty is similar to a posterior approach to a robotic-assisted laparoscopic prostatectomy and can be done utilizing both multi-port and single port robotic platforms. Neovaginal canal depths and widths of 14 ± 0.7 cm by 3.6 ± 0.2 cm respectively can be obtained. Peritoneal flaps can also augment neovaginal depth by approximately 5 cm beyond the length of a skin graft or flap, proving advantageous in cases of genital hypoplasia or canal depth loss requiring revision. Patients typically report high sexual satisfaction following vaginoplasty.

The robotic peritoneal vaginoplasty as a genital gender affirming surgery offers additional neovaginal depth, with reported low complication rates, acceptable cosmesis, and satisfactory sexual function. Ongoing research in alternative grafts and revision remain to be studied.