Step-By-Step Surgery Video of Robotic Peritoneal Flap Vaginoplasty at NYU Langone

184
u/trans_Gaines employed by NYU Langone Health Gender Affirming Surgery program
employed by NYU Langone Health Gender Affirming Surgery program
Wed Oct 20 15:01:39 2021 UTC
(44 comments)

DISCLOSURE: I work as a research associate at NYU Langone Health in the gender affirming surgery program. My views do not represent the institution, I am posting here in a personal capacity.

The journal Plastic & Reconstructive Surgery has made a step-by step, peer reviewed video on robotic peritoneal flap vaginoplasty open access for the next month, rather than behind the usual paywall. Some people call this "peritoneal pull through". It is an uncensored video with blood, surgical tools, etc as forewarning.

You can find the videos within the larger article: https://journals.lww.com/plasreconsurg/Fulltext/2021/08000/Penile_Inversion_Vaginoplasty_with_Robotically.29.aspx

Direct link to part one: https://journals.lww.com/plasreconsurg/Fulltext/2021/08000/Penile_Inversion_Vaginoplasty_with_Robotically.29.aspx#video1

Direct link to part two: https://journals.lww.com/plasreconsurg/Fulltext/2021/08000/Penile_Inversion_Vaginoplasty_with_Robotically.29.aspx#video2

Direct link to part three: https://journals.lww.com/plasreconsurg/Fulltext/2021/08000/Penile_Inversion_Vaginoplasty_with_Robotically.29.aspx#video3

all 44 comments


20
u/BeingElla
Wed Oct 20 16:38:49 2021 UTC
(1 child)

A little tough to watch but interesting, at least to me, an old RN. It’s graphic.

11
Wed Oct 20 20:07:22 2021 UTC
(0 children)

Yeah, I'm normally pretty iron stomached and I have a rule where I want to see a video of any procedure I want done on myself, but I had the full ears-ringing, heartrate way up, nausea reaction last time I watched a video of a peritoneal flap vaginoplasty. I think it was the camera actually going inside that did it, organs look different on the inside than the outside.

9
u/AllAboutWaxing
Thu Oct 21 03:02:37 2021 UTC
(0 children)

I want to thank you so much for this. I am just starting electrology school and this will help me understand the complexity of what some of my future clients will be going through as I help them clear hair for this very procedure.

It was quite graphic and I can't even imagine what the recovery must feel like but after watching I can't help but think the 3 children I birthed vaginally would not even remotely compare to the pain.

Please let everyone know including the patient how much we appreciate this.

u/HiddenStill
Wed Oct 20 15:06:53 2021 UTC
(6 children)

Mod approved.

Wed Oct 20 19:37:59 2021 UTC
*
(5 children)

[deleted]

1
Wed Oct 20 19:47:47 2021 UTC
(4 children)

I’ve no idea what it is. I don’t like surgical videos, so not looking.

I marked the post as nsfw just in case reddit shows a pic of it.

Wed Oct 20 20:07:59 2021 UTC
(3 children)

[deleted]

1
employed by NYU Langone Health Gender Affirming Surgery program
OP
Wed Oct 20 20:30:16 2021 UTC
(1 child)

It's not animation, but very much an in-surgery video. Lots of blood, view from inside the body because of the robot camera, etc.

1
Thu Oct 21 04:39:55 2021 UTC
(0 children)

I’ve come across it, but I find it disturbing so didn’t watch it.

10
u/Kim_or_Kimmys_Fine
Wed Oct 20 16:18:43 2021 UTC
(0 children)

This is awesome!

5
u/krys88
Fri Oct 22 04:25:25 2021 UTC
(8 children)

If anyone wishes to download the videos, here's a simple bash script you can run. It assumes you already have ffmpeg in your path. Cheers.

```

!/bin/bash

ffmpeg -i https://cfvod.kaltura.com/hls/p/1315631/sp/131563100/serveFlavor/entryId/1_m6jtv3il/v/1/ev/9/flavorId/1_ltajejcn/name/a.mp4/index.m3u8 -c copy pt1.ts ffmpeg -i https://cfvod.kaltura.com/hls/p/1315631/sp/131563100/serveFlavor/entryId/1_h9j52o8l/v/1/ev/9/flavorId/1_0yav20u6/name/a.mp4/index.m3u8 -c copy pt2.ts ffmpeg -i https://cfvod.kaltura.com/hls/p/1315631/sp/131563100/serveFlavor/entryId/1_df07fifk/v/1/ev/9/flavorId/1_7rsi1636/name/a.mp4/index.m3u8 -c copy pt3.ts

cat <<EOF > files.txt file 'pt1.ts' file 'pt2.ts' file 'pt3.ts' EOF

ffmpeg -f concat -i files.txt -c copy surgery.mp4

rm pt1.ts pt2.ts pt3.ts files.txt ```

Fri Feb 4 04:56:59 2022 UTC
(3 children)

[removed]

1
Fri Feb 4 05:07:22 2022 UTC
*
(0 children)

It look like reddit is removing your comment and I can’t get it back. Perhaps if you edit it a bit so it’s not a valid url it will “work”.

Edt: download links for the video and pdf are in the post history of u/krys88

1
u/krys88
Sat Feb 12 00:44:58 2022 UTC
(1 child)

If those links don't work, here's a bit.y redirect
https://bit.ly/3HMmtuc
https://bit.ly/3rKDqQf

2
Tue Oct 11 22:59:21 2022 UTC
(0 children)

Video now also behind a paywall

https://imgur.com/a/cQYElbf

1
Mon Oct 10 09:37:21 2022 UTC
(3 children)

No longer available, any chance you saved them?

1
Wed Nov 16 22:37:42 2022 UTC
(1 child)

The links in the script are still up. You can either watch it in 3 parts by going to the links directly, or make it one video using the script.

1
Sat Nov 19 02:08:13 2022 UTC
(0 children)

Odd, it didnt work for me before, but it does now. Thanks.

11
u/KyubiNoKitsune
Wed Oct 20 21:05:46 2021 UTC
(5 children)

I think one of the big reasons why I wanted to go to Suporn was that he didn't remove any of the glans, he just split it and moved it around, watching them cut off like 60% of the nerve endings has me wondering why. Hell, hide it under the skin if you need to but don't throw it away.

Otherwise this was super interesting and you can see that they're a vary competent surgeon. Thanks OP

6
Thu Oct 21 04:42:29 2021 UTC
(0 children)

Suporn’s method also works as a backup/spare if anything bad happens to the clitoris. Like necrosis.

4
Wed Oct 20 23:14:55 2021 UTC
(3 children)

Oh God, they really cut out all that? Makes zero sense, what benefits would that get? There's gotta be room to stuff it all under the skin. Glad you brought this up, major flaw in the surgery, enough to make it unthinkable if that's required.

11
employed by NYU Langone Health Gender Affirming Surgery program
OP
Thu Oct 21 00:00:06 2021 UTC
(1 child)

There is a portion that is de-epithelialized (outer skin layer removed, "lateral wings de-epthelialized" at 1:20 in video two, act of this occurs at 1:44) and used internally within the clitoris to preserve as much glans tissue as possible, but at the end of the day yes, much is removed in order to make the clitoris. The benefit is the smaller clitoris than the original glans it was made from, though this a personal pro/con judgement. It's not required, there have been patients who requested less be removed, as they were fine having a larger clitoris.

5
Thu Oct 21 08:44:15 2021 UTC
(0 children)

So instead of removing the centre part, wouldn't it be a possibility to rather split it in the middle and fold it into itself, so where the C shape is pulled together to make the clitoris rather just make a split in the middle, fold the two flaps down and put stitches in the exact same place as on the C to pull the two pieces together, it would give the clit more depth without increasing the size.

5
Thu Oct 21 08:40:01 2021 UTC
(0 children)

Yeah, a large part got removed. I mean, I get it for aesthetic reasons, it makes the clit look really nice, I love the way that part is done, but I feel like the rest could have been saved. I feel like nerve density should be taken into consideration when doing something like this. The glans just doesn't have the same nerve density as the clit, cutting it down to clit size is reducing sensitivity so much. I think I'd rather have my alien vagina thanks.

4
u/TransMontani
Thu Oct 21 04:35:42 2021 UTC
(0 children)

Wow! This was super helpful! I’m having this procedure in less than three weeks and just today, I thought to myself, “I wish there was some way I could know what they’re going to do for me.” Now I know and I am undaunted, but my curiosity has been satisfied.

Thank-you for posting this.

5
u/Jessie189c
Wed Oct 20 17:42:08 2021 UTC
(0 children)

Will definitely watch this later, thank you for sharing!

2
u/[deleted]
Wed Oct 20 22:46:22 2021 UTC
(1 child)

I’m what you would call weak, so I barley made it through the first two minutes, but still neat stuff!

2
Thu Oct 21 03:04:50 2021 UTC
(0 children)

If you can go back and watch the last half of the 3rd video... great to see the end where it all comes together.

2
u/sharinganuser
Thu Oct 21 02:43:03 2021 UTC
(0 children)

Dang, this made me a bit queasy even as someone who subs to gore subreddits and who has had vaginoplasty herself. Just something about knowing that it happened to you makes it that much easier to put yourself into the position of the person in the video?

2
u/cbraeburn
Thu Oct 21 03:39:39 2021 UTC
(1 child)

Thank you for sharing this! This was the surgery that I had with Dr. Gladys Ng at UCLA. She went through the surgery program with Dr. Bluebond-Langer in NYC. Still cringy to see the process though!

4
employed by NYU Langone Health Gender Affirming Surgery program
OP
Thu Oct 21 14:09:01 2021 UTC
(0 children)

We do have a one year urology fellowship program, which has been completed by Dr. Geolani Dy (OHSU), Dr. Min Jun (Crane Center), and Dr. Nabeel Shakir (Henry Ford Health System). Other surgeons come to watch and discuss, but the surgeons I mentioned are the ones who have completed a full training program in this method.

2
u/EnsedaFustian
Thu Dec 30 02:33:22 2021 UTC
(2 children)

The links keep telling me "Subscriber Access Only," and then there's a shopping cart with $1350 attached to it.

2
employed by NYU Langone Health Gender Affirming Surgery program
OP
Sun Jan 2 19:41:22 2022 UTC
(1 child)

Unfortunately the period where the video was open-access has ended. Perhaps one of the other commenters in the thread who published a script for downloading the video retained a copy? Alternately, you may be able to access through a local library system.

1
Mon Jan 3 14:11:42 2022 UTC
(0 children)

Thanks for checking on that for me. :)

2
u/PrinceLeWiggles
Wed Oct 20 19:40:07 2021 UTC
(0 children)

This is a neat watch. Thanks for sharing!

It is graphic for those who are wondering so don't watch it if you can't watch blood in surgery

2
u/NoelleElizabeth68
Wed Oct 20 20:03:23 2021 UTC
(0 children)

Can’t wait for mine!

1
u/jadediaz2008
Wed Oct 20 21:40:01 2021 UTC
(0 children)

Thank you for sharing these videos with our community!

1
u/its_shivers
Wed Oct 20 22:09:25 2021 UTC
(0 children)

Fascinating! I'm no surgeon but I wish I could have combined some features from this into mine.

1
u/heyImMissErin
Wed Oct 20 23:28:16 2021 UTC
(0 children)

Thank you so much for sharing!! I’ve been looking for a surgical video like this for a while

1
u/uconnhusky
Thu Oct 21 02:01:26 2021 UTC
(0 children)

As someone who works in the industry, the shoutout to Vicryl was baffling and hilarious.

1
u/cesarioinbrooklyn
Thu Oct 21 02:54:39 2021 UTC
(0 children)

Yup, I am getting that surgery with Drs. Bluebond-Langner and Zhao in a little over a year, but you could not pay me enough to watch that video! 😳

1
u/kai_onlineAAA
Thu Oct 21 04:25:01 2021 UTC
(0 children)

hell yes this is amazing

1
u/eXcUsEm3mEwTf
Thu Oct 21 09:42:36 2021 UTC
(0 children)

Alright we’ll I didn’t make it through the whole thing but it is very interesting. I think I’m just not gonna think about all those specific little details in the future hopefully when I’m able to have bottom surgery

1
u/[deleted]
Thu Oct 21 10:41:09 2021 UTC
(0 children)

This is great, thank you!

1
u/ashleyjm
Sat Oct 23 00:54:53 2021 UTC
*
(0 children)

Thank you for this informative post! These videos reveal far more details than the video Dr. Jun shared with me shortly after my consult at NYU over 15-mos. ago. I now know exactly how my vaginoplasty will proceed in 166-days, getting lucky with a surgery cancellation slot notwithstanding.

It can’t come soon enough.

1
u/ashleyjm
Tue Nov 9 12:07:41 2021 UTC
(0 children)

Have to share that before rolling out of the rack this morning, watching these videos for the umpteenth time was how I started my day. Upside, I learn and better understand what I will go through every time I watch. Downside, the guitar music playing in the background is now permanently stuck in my head!

I do have a few questions I will send to Dr. RBbL to further my understanding. Thank you u/trans_Gaines for making these videos available❣️👍👍