Split thickness skin graft for cervicovaginal reconstruction in congenital atresia of cervix

Original Video Article

Capsule:
We introduce a new technique that combines laparoscopic and vaginal cervicovaginal reconstruction using split thickness skin graft in patients with congenital atresia of the cervix.

Authors:
Xuyin Zhang, M.D., Ph.D., Han Tiantiana, M.D., Ph.D., Jingxin Ding, M.D., Ph.D., Keqin Hua, M.D., Ph.D.

Volume 104, Issue 4, Page e9

Abstract:

Objective:
To introduce a new technique that combines laparoscopic and vaginal cervicovaginal reconstruction using split thickness skin graft in patients with congenital atresia of the cervix.

Design:
Video article introducing a new surgical technique.

Setting:
University hospital.

Patient(s):
A 16-year-old patient with congenital cervical atresia, vaginal dysgenesis, and ovarian endometrial cyst.

Intervention(s):
An original technique of combined laparoscopic and vaginal cervicovaginal reconstruction using split thickness skin graft for cervicovaginal reconstruction.

Main Outcome Measure(s):
A midline incision at the vaginal introitus was made, and a 9-cm canal was made between the bladder and the rectum using sharp and blunt dissection along the anatomic vaginal route, with the aid of laparoscopy to ensure correct orientation. A 14 × 12 cm split thickness skin graft was harvested from the right lateral thigh. By laparoscopy, the level of the lowest pole of the uterine cavity was exposed and the cervix was incised by shape dissection. The proximal segment of the harvested skin to the lower uterine segment was secured, and the distal segment was sutured with the upper margin of vulva vaginally. Surgical technique reports in anonymous patients are exempted from ethical approval by the Institutional Review Board. The patient gave consent to use the video in the article.

Result(s):
The procedure was successfully completed. Since February 2013, our experiences of combined laparoscopic and vaginal cervicovaginal reconstruction using split thickness skin graft in 10 patients with congenital atresia of cervix were positive, with successful results and without complications or cervical, or vaginal stenosis.

Conclusion(s)
Our technique is feasible and safe for congenital atresia of cervix, with successful results and without complications or cervical or vaginal stenosis.

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