Optimizing the Laparoscopic Vecchietti Procedure: Tips and Tricks.

Background: The Vecchietti procedure is a staged procedure that, through use of an acrylic olive, allows for expedited traction and dilation to create a neovagina in patients with congenital vaginal agenesis. Although the steps are fairly standardized for the laparoscopic Vecchietti procedure, we have appreciated specific nuances in technique that have optimized our surgical approach and efficiency.

Case: We present a case of congenital vaginal agenesis in a genetically female patient who completed neovaginal creation using the laparoscopic Vecchietti technique. During this case, we review each step of the procedure and offer technical strategies to enhance efficiency and effectiveness in the operating room. We also describe these specific preoperative, intraoperative, and postoperative considerations in a video.

Conclusions: This optimized Vecchietti procedure, or traction vaginoplasty, is an excellent option for neovagina creation in those patients with vaginal agenesis. With the use of our techniques, we have had successful cosmetic and functional outcomes.