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Robotic Peritoneal Flap Revision Vaginoplasty: Step-by-Step Technique: Tips & Tricks
V Celis1, V I Rodríguez1, L K Fumero1
1The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, 1441 Eastlake Ave., Suite 7416 90089-9178, Los Angeles, CA, USA.
International Urogynecology Journal
|April 13, 2026
Summary
Robotic peritoneal flap vaginoplasty revision is a safe and feasible surgical option for transgender women experiencing vaginal canal stenosis after initial vaginoplasty. This technique effectively restores vaginal patency and depth.
Area of Science:
- Surgical innovation in gender-affirming care
- Minimally invasive reconstructive surgery
- Transgender women's health
Background:
- Penile inversion vaginoplasty is common for transgender women but has high revision rates.
- Vaginal canal stenosis or shortening is a frequent functional complication requiring revision surgery.
- Revision vaginoplasty presents unique surgical challenges, particularly in flap reconstruction.
Purpose of the Study:
- To present a step-by-step technique for robotic peritoneal flap revision vaginoplasty.
- To discuss the indications, challenges, and postoperative management of this revision procedure.
- To evaluate the feasibility and outcomes of robotic revision vaginoplasty.
Main Methods:
- Detailed description of the robotic peritoneal flap vaginoplasty revision technique.
- Inclusion of surgical tips and step-by-step guidance.
- Outline of postoperative care, including vaginal packing, catheter management, and discharge planning.
Main Results:
- Robotic peritoneal flap vaginoplasty revision is feasible and safe.
- Average operative time was 3 hours with an estimated blood loss of 20 ml.
- Postoperative management included early discharge, with serial vaginoscopies to ensure patency.
Conclusions:
- Harvesting a peritoneal flap is feasible even after prior perineal flap surgery.
- Robotic revision vaginoplasty effectively re-establishes vaginal canal patency and depth.
- This procedure offers a viable solution for transgender women needing vaginal reconstruction revision.
