(Video Poster 13) Microdebrider-assisted Colpocleisis: A Novel Technique

Objectives: We propose a novel technique using microdebrider assistance to resect vaginal epithelium during colpocleisis, and demonstrate our short-term outcomes.

Methods: In our study, we demonstrate the use of a handheld microdebrider instrument to resect vaginal epithelium in an ex vivo tissue model. Additionally, we exhibit its use in vivo during total colpocleisis and measure its efficiency against traditional de-epithelialization. We report short-term (6-weeks) clinical outcomes for two patients in our ongoing series.

Clinical Relevance: Pelvic organ prolapse (POP) is a common condition caused by weakening of pelvic floor muscles and connective tissue, leading to bulging of the pelvic organs into the vaginal canal. Colpocleisis is a transvaginal obliterative surgery for repair of advanced POP in patients who do not desire preservation of coital function. This surgery involves removing the epithelial lining of the vagina, followed by closure of the vaginal canal. De-epithelialization can be a time-consuming step during a procedure which is otherwise meant to provide definitive results while limiting operative times and risk of complications.
A microdebrider is a surgical instrument often used by otolaryngologists for resection of hard tissue, soft tissue, and bone. Its use has previously been described for resection of vaginal epithelium in gender-affirming vaginectomy. We demonstrate the successful use of a microdebrider in POP surgery. Additional long-term clinical studies are warranted.