Surgical Film Library-Vulvogainal Reconstruction Following Resection

Vulvogainal Reconstruction Following Resection

Video Transcription

Video Summary

This video discusses vaginal reconstruction primarily using the VRAM flap, which harvests abdominal rectus muscle, skin, and fascia, supplied by the deep inferior epigastric vessels. VRAM flaps obliterate dead space post-surgery, close skin defects, and reconstruct the vagina, although the reconstructed skin will be insensate but functional for intercourse. Secondary options include thigh-based gracilis or profunda artery perforator flaps, which may have limitations. The omentum flap assists in dead space obliteration. Surgical steps include careful flap harvesting, tunneling into the pelvis, and insetting for vaginal reconstruction. Postoperative care restricts sitting beyond 45 degrees for weeks; intercourse or dilation begins after 3 months.

Asset Subtitle

Michelle Coriddi, United States

Meta Tag

Route Open

Skill Level Expert

Surgical Location Vulva

Keywords

Open

Vulva

Expert

vaginal reconstruction

VRAM flap

deep inferior epigastric vessels

gracilis flap

postoperative care