Could Training in an Anatomical Model Be Useful to Teach Different Neovagina Surgical Techniques? A Descriptive Study about Knowledge and Experience of Techniques for Neovagina Surgery

Abstract

Neovagina surgery in patients with vaginal agenesis is rare. No consensus exists regarding the best surgical technique. The aims of the current study were to show a new Thiel-embalmed cadaveric model to teach the surgical steps for different techniques of neovagina surgery and to evaluate opinions of this surgical teaching procedure. Four techniques—modified McIndoe, Vecchietti, Davydov, and vulvoperineal pediculated flaps—were recorded using an external camera and/or laparoscopic vision during their execution in a dissection room on “feminized” male cadavers. To determine the opinion of this teaching model, we designed an anonymous online survey that was available to participants via a computer application. After watching the video, more than 92% of participants agreed that feminized male cadavers were an excellent procedure for teaching these surgical techniques. Before watching this video, the most employed techniques were the McIndoe and Vecchietti procedures. After watching the video, modified McIndoe and vulvoperineal flaps were preferred by participants because they were considered to be easier to perform. It was considered that this model was useful for training neovagina techniques and, moreover, it should be recommended before techniques were performed on a real patient. Further investigation is needed to validate this model.

Retrospective comparative cohort study of neovagina creation by modified Vecchietti-laparoendoscopic single-site surgery for Mayer-Rokitansky-Küster-Hauser syndrome

“…Currently, a variety of surgical methods for neovagina formation have been reported and analyzed, such as lining the cavity with various types of materials after dissecting the space between the rectum and bladder, including covering the autogenous skin graft (McIndoe procedure) ( 5 ), using peritoneum from the pouch of Douglas (Davydov procedure) ( 6 , 7 ), or performing bowel vaginoplasty with a rectosigmoid segment ( 8 ). Vecchietti vaginoplasty is a surgical procedure that meets all of the above needs.…”