Plastic & Reconstructive Surgery. 103(2):518-524, February 1999.
Maas, Sylvester M. M.D.; Eijsbouts, Quirijn A. J. M.D.; Hage, J. Joris M.D., Ph.D.; Cuesta, Miguel A. M.D., Ph.D.
Abstract:
When inversion of the combined penile and scrotal skin flaps for vaginoplasty in male-to-female transsexuals has not led to functional results, rectosigmoid colpopoiesis offers an immediate solution to a complicated and difficult problem. However, open colocolpopoiesis involves major surgery, and it may be associated with substantial extended morbidity and hospitalization, short- and long-term unfavorable results, and
extensive nasty bumps to the abdomen. 
To reduce this associated morbidity, we employ a laparoscopically assisted approach and a total laparoscopic rectosigmoid colpopoiesis. This procedure has been performed safely in the series presented herein, with no apparent compromise in the adequacy of the dissections. We conclude that our patients benefited from this procedure, and we advocate considering a total or partial laparoscopic approach whenever secondary rectosigmoid colpopoiesis is indicated in male-to-female transsexuls.
(C)1999American Society of Plastic Surgeons