腹腔镜改良Davydov技术阴道成形术：手术步骤与技术要点。
Laparoscopic modified Davydov's technique for vaginoplasty: operative steps and technical pearls.
文献信息
| PMID | 42759742 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Stefano Scarperi |
| 作者单位 | Division of Gynaecology and Obstetrics (B), Azienda Ospedaliera Universitaria Integrata di Verona, Italy; Dipartimento ad attività integrata materno-infantile, Verona, Italy. Electronic address: stefano.ferla2@studio.unibo.it. |
| 期刊 | American journal of obstetrics and gynecology |
| SCI 分区 | Q1 |
| IF | 8.5 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景： 苗勒管发育不全综合征是一种先天性病症，特征为46,XX核型正常、卵巢功能正常且第二性征正常的女性出现子宫和阴道发育不全。它是原发性闭经最具挑战性的病因之一，具有显著的解剖、功能和心理影响。方法：已提出多种手术和非手术技术用于阴道重建；然而，尚无普遍接受的标准。在手术选择中，腹腔镜Davydov手术因其微创性和良好的解剖与功能结局而被广泛接受。本视频文章介绍标准化的腹腔镜Davydov新阴道成形术，阐明关键解剖标志和技术步骤。我们报告一例21岁苗勒管发育不全女性，无相关病史，表现为原发性闭经，接受了腹腔镜与阴道联合入路。结果：腹腔镜探查后，切开膀胱与直肠之间的腹膜，并分离直肠膀胱间隙。经会阴置入12-mm穿刺器，以引导将游离腹膜吻合至阴道前庭黏膜，从而创建连续的新阴道通道。6个月随访时，阴道镜检查显示新阴道黏膜上皮化良好、碘染色阳性，最终阴道长度为11 cm。未报告泌尿或功能并发症。结论：本视频展示了一种标准化且可教学的腹腔镜技术，可能有助于改善苗勒管发育不全患者的功能和心理社会结局。
英文摘要
Müllerian agenesis syndrome is a congenital condition characterized by uterine and vaginal agenesis in women with normal 46,XX karyotype, normal ovarian function, and normal secondary sexual characteristics. It represents one of the most challenging causes of primary amenorrhea, with significant anatomical, functional, and psychological implications. Several surgical and non-surgical techniques have been proposed for vaginal reconstruction; however, no universally accepted standard exists. Among surgical options, the laparoscopic Davydov procedure has gained wide acceptance due to its minimal invasiveness and favorable anatomical and functional outcomes. This video article presents a standardized laparoscopic Davydov neovaginoplasty, illustrating key anatomical landmarks and technical steps. We report the case of a 21-year-old woman with Müllerian agenesis, no relevant medical history, and primary amenorrhea, who underwent a combined laparoscopic and vaginal approach. Following laparoscopic inspection, the peritoneum between the bladder and rectum was incised, and the recto-vesical space was developed. A 12-mm trocar was inserted transperineally to guide the anastomosis of the mobilized peritoneum to the vaginal vestibular mucosa, thereby creating a continuous neovaginal canal. At 6-month follow-up, vaginoscopy showed a well-epithelialized, iodine-positive neovaginal mucosa with a final vaginal length of 11 cm. No urinary or functional complications were reported. This video demonstrates a standardized and teachable laparoscopic technique that may contribute to improving functional and psychosocial outcomes in patients with Müllerian agenesis.