摘要
目的:探讨机器人辅助腹膜代阴道成形术在治疗男变女易性症患者阴道再造中的应用。方法:2021年5月经手术治疗男变女易性症患者2例,使用达芬奇机器人Xi辅助游离切取适量盆底壁腹膜构造阴道黏膜部,自盆底牵入预先分离好的穴道内,最后将再造阴道黏膜部远端与预先构建的大阴唇及尿道外口边缘缝合形成完整阴道。结果:达芬奇机器人Xi进行盆腔腹膜游离操作时精准灵活,术中出血少,再造阴道无狭窄,有足够深度和宽度,阴道壁柔软、湿润、富有弹性,贴近生理阴道功能,手术损伤小,无盆腔脏器损伤,无血管神经损伤,阴道腹膜和阴蒂成活良好,外阴形态美观、伤口愈合好。结论:达芬奇机器人Xi辅助腹膜代阴道成形术应用于男变女易性症患者治疗中,效果好、损伤小、恢复快,值得在临床中推广应用。
Objective:To explore the application of robot-assisted peritoneal vaginoplasty in the treatment of transsexuality from male to female.Methods:2 cases of transsexuality from male to female were performed with Da Vinci Xi robotic surgical system in May 2021.Part of pelvic floor peritoneum was cut and pulled from the pelvic floor into the pre-separated canal to construct vaginal mucosa.The distal part of the reconstructed vaginal mucosa was sutured with the preconstructed labia majora and the outer edge of the urethra to form a complete vagina.Results:The Da Vinci Xi system has the advantages of accurate and flexible operation in separating pelvic floor peritoneum,which could cause less intraoperative bleeding or surgical injury.The reconstructed vagina was deep and wide enough and close to physiological vaginal function.With soft,moist and elastic vaginal wall and good survival of vaginal peritoneum and clitoris,it leads no stricture of the reconstructed vagina or injury to pelvic organs.No vascular or nerve injury was found.The shape of vulva was beautiful and the wound healed well.Conclusion:Da Vinci Xi robot-assisted peritoneal vaginoplasty has advantages of good effect,small trauma and quick recovery in the treatment of male to female transsexuality,it is worth of clinical promotion.
作者
张勤
王海琳
郭树忠
高建建
刘平
赵晶
辛佳纯
王雪芬
芦小珊
ZHANG Qin;WANG Hailin;GUO Shuzhong;GAO Jianjian;LIU Ping;ZHAO Jing;XIN Jiachun;WANG Xuefen;LU Xiaoshan(The First School of Clinical Medicine,Gansu University of Chinese Medicine,Lanzhou 730000,China;Gynecologic Oncology Hospital,Xi’an International Medical Center Hospital,Xi’an 710100,China;Plastic Surgery Hospital,Xi’an International Medical Center Hospital,Xi’an 710100,China;The First School of Clinical Medicine,Lanzhou University,Lanzhou 730000,China)
基金
甘肃省科学技术厅自然科学基金项目(20JR5RA151)。
关键词
机器人辅助手术
腹膜代阴道成形
易性症
性别重置手术
Robot-assisted surgery
Peritoneal vaginoplasty
Transsexualism
Sex reassignment surgery
