Penile Inversion Vaginoplasty with Robotically Assisted Peritoneal Flaps

Penile inversion vaginoplasty is the most common surgical technique for gender-affirming genital reconstruction in trans-feminine individuals. 122]3 This video describes the technique in step-by-step narration of both the external vulvoplasty and internal canal dissection.As part of our multidisciplinary approach to transgender care, this operation is performed by a plastic surgeon and a urologist.To provide additional vaginal depth, we raise peritoneal flaps with a robotically assisted laparoscopic approach. 4The first reported peritoneal flap vaginoplasty was performed by Ksido et al. 5 in 1933 for patients with Mayer-Rokitansky-Kster-Hauser syndrome.Davydov and Zhvitiashvili subsequently popularized the technique. 6Based on this technique, our group published a series of 41 patients undergoing gender-affirming vaginoplasty with robotically assisted peritoneal flaps.