About Video

This video is a case of 26-years-old female patient, present complaints primary amenorrhea, inability to have sexual contact since marriage 15 days back. Sonography: a hypoplastic uterus with normal looking ovaries. Chromosome analysis—46 XX. Preoperative diagnosis: Müllerian agenesis—Mayer-Rokitansky-Kuster-Hauser syndrome. Vaginal procedure—Bladder emptied and cytoscopy done. Rectal probe kept to safeguard the rectum with downward direction. Laparoscopic procedure—Big straight needle with ethibond no. 2 pierced through the hymenal fossa. Needle pulled out with help of needle holder. Two microlaparoscopy ports positioned medial to inferior epigastric artery. Micrograsper introduced medial to inferior epigastric vessel subperitoneally to emerge close to the nodule of the uterus. Micrograsper picks-up the traction suture. Now micrograsper is pulled back towards the abdominal wall and the ethibond suture through the subperitoneal path emerges at anterior abdominal wall. Here they are attached to traction device. Same technique applied contralaterally. Finally, olive which is attached to traction sutures is fixed at hymenal fossa. To check the integrity of bladder a cystoscopy is done to see for any inadvertent suture passage through bladder. A finger in the rectum confirms there is no suture passage through rectum. Follow-up: Every alternate day, 1 cm traction is provided on the olive by the traction device. On seventh day, olive and traction device removed and the vaginal length is assessed. It accommodates two fingers easily in their full length. Condom with mould is given for one month after which intercourse is advised. Patients reported very satisfactory coital function with good vaginal lubrication, as it utilizes the vagina’s own squamous epithelium to be invaginated into the neovagina. In most of the other techniques skin graft, amniotic membrane or peritoneum is brought down. This method scores over others due to its simplicity of performance and superior functional results.