Small intestinal submucosa patch for extensive vaginal endometriosis resection

Area of Science:

• Gynecology
• Surgical Innovation
• Regenerative Medicine

Background:

• Endometriosis can necessitate extensive vaginal resection, potentially leading to vaginal shortening and stiffness.
• Rectovaginal endometriosis poses surgical challenges due to its proximity to critical structures.
• Minimally invasive surgical approaches are preferred to reduce morbidity.

Observation:

• A 32-year-old nulliparous woman presented with a large rectovaginal endometriosis nodule involving vaginal and rectal mucosa.
• A two-stage surgical approach was employed: initial laparoscopic rectal resection followed by a laparoscopic second-look with vaginal resection.
• A porcine small intestinal submucosa (SIS) patch was utilized during the vaginal reconstruction phase.

Findings:

• The SIS patch was successfully used to reconstruct the resected vaginal segment.
• The patient experienced no vaginal stiffness or retraction post-operatively.
• The SIS patch facilitated preservation of vaginal length and function.

Implications:

• Porcine small intestinal submucosa patches represent a viable option for vaginal reconstruction after endometriosis resection.
• This technique may help mitigate functional deficits associated with extensive vaginal surgery for endometriosis.
• Further research is warranted to evaluate long-term outcomes and applicability in diverse patient populations.