Robotic Vaginectomy to be Offered in US for the First Time

Thursday October 15, 2020

Dr. Sherman Leis, founder of The Philadelphia Center for Transgender Surgery, has announced a new robotic vaginectomy procedure developed for transmasculine patients.

Dr. Leis, working with gynecologist Dr. John Missanelli, incorporates the technology and technique recently established for robotic hysterectomy to improve upon and simplify the traditional technique of open vaginectomy. The new procedure facilitates an operation that is easier on the patient while also cutting down on surgery time and eliminating the need to make an extensive open pelvic vaginectomy dissection.

The new concept for the robotic technology allows Drs.' Leis and Missanelli to essentially eliminate the vagina, uterus, tubes and ovaries through a simpler, safer and quicker procedure. The robotic mechanism improves access inside the pelvis to remove the vaginal walls along with the total hysterectomy. Further, the small incisions made for this technology vastly differ from the long, horizontal or vertical incision utilized in earlier open techniques, reducing a visible reminder of the patient's previous dysphoria. Compared to a traditional open procedure, surgery time is reduced by an hour or more.

"Helping my transgender patients feel comfortable in their own skin includes not only surgery, but the varied processes of post-op recovery from physical healing to internalizing the changes to one's body," explains Dr. Leis. "The success of robotic hysterectomies over the last five years led us to see that there was a way we could utilize these robotic techniques on procedures to eliminate the vagina along with the uterine structures to improve and streamline the surgery for FTM patients."

Coronavirus lockdown conditions created delays in his original timeline to begin performing the surgery, with hospitals cancelling all elective procedures for months. Yet demand has continued to increase, with several robotic vaginectomies already on Dr. Leis's schedule for this fall.

"It's been a pleasure to work across specialties with Dr. Missanelli to bring this procedure to fruition," notes Leis. "We're thrilled about what the robotic vaginectomy means for patients' general health as well as their transition. As more surgeons become trained in robotic techniques, we expect that robotic hysterectomy and vaginectomy will become the standard of care in the female to male patient undergoing genital reassignment surgery."