Peritoneal Vaginoplasty in Gender Diverse Patients

Abstract Purpose of Review To describe robotic-assisted peritoneal vaginoplasty in the genital gender affirming surgical setting and demonstrate existing surgical outcomes. Recent Findings Robotic peritoneal vaginoplasty is similar to a posterior approach to a robotic-assisted laparoscopic prostatectomy and can be done utilizing both multi-port and single port robotic platforms. Neovaginal canal depths and widths of 14 ± 0.7 cm by 3.6 ± 0.2 cm respectively can be obtained. Peritoneal flaps can also augment neovaginal depth by approximately 5 cm beyond the length of a skin graft or flap, proving advantageous in cases of genital hypoplasia or canal depth loss requiring revision. Patients typically report high sexual satisfaction following vaginoplasty. Summary The robotic peritoneal vaginoplasty as a genital gender affirming surgery offers additional neovaginal depth, with reported low complication rates, acceptable cosmesis, and satisfactory sexual function. Ongoing research in alternative grafts and revision remain to be studied.