Objective Evaluation of the suitability of total
laparoscopic hysterectomy as an adjunctive procedure in the female-to-male
transsexual reassignment surgery. Surgical reassignment surgery in the
transsexual is not a frequent procedure. The expertise of an gynaecologist in
the treatment of the syndrome is necessary as well as the input of other
specialists such as psychiatrists, psychologists, plastic and reconstructive
surgeons and urologists. The gynaecological surgeon usually performs the
hysterectomy and in some cases also colpectomy.
Subject Case report
Methods The authors analyse their own
surgical experience with the above mentioned syndrom in the patient in whom
the surgical reconstruction took place in two phases. In the first phase the
Total Laparoscopic Hysterectomy with Bilateral Salpingo Ophorectomy (TLH, BSO)
was performed. Of note is that this procedure was chosen due to extremely
narrow vaginal canal with no uterine descent. For the second phase of the
surgery the patient was referred to the urological surgeon.
Results The duration of the surgery was 54
minutes, the blood loss was not measurable. We have not encountered any per-
and postoperative complications and the patient was discharged after 48 hours.
Conclusion We conclude that the TLH/BSO
approach has enabled to us to preserve the vital structures needed for
reconstruction of external genitalia, e.g. inferior epigastric vessels and
rectus muscles were not disturbed. This approach is complex and has clear
advantages in comparison to vaginal hysterectomy, laparoscopic assisted
vaginal hysterectomy or even total abdominal hysterectomy. It does guarantee a
smooth removal of both ovaries and it is not dependent on the size of the
vagina or uterine descent.
Citation:
Ceska Gynekol 2001 May;66(3):193-5 an article
published on the Internet by PubMed <http://www.ncbi.nlm.nih.gov/>
