Design: Case Report

Setting: Patient underwent Robotic (CMR Robotic system ) vaginoplasty. Patient in lithotomy position under anaesthesia. Procedure done by Experienced & Qualified team

Patients or Participants: 7 year unmarried patient came with primary amenorrhea with MRKH syndrome blind vaginal pouch, karyotyping 46XX with normal secondary sexual charecters

Interventions: Robotic vaginoplasty by using peritoneum over rectum to create a neo-vagina

Measurements and Main Results: In modern era, minimal invasive procedure (laparoscopy, robotic ) has replaced abdominal and vaginal approach of vaginoplasty. In this patient peritoneal flap is raised from rectum by staying in between the uterosacral ligament. Always remember fact “FAT BELONGS TO RECTUM IS DICTUM". Bladder dissected. Perineum opened at vaginal dimple making hole and peritoneal flap pulled below & sutured at mucocutaneous junction at introitus at 3,5,7, 9, clock position. purse string suture then taken to closed the peritoneum and it act as apex of neo-vagina. Maould is kept for 7days, after 7days mould exercise explained to patient. with no complications. with long term follow up, patient had good anatomical and functional vagina of length 8cm.

Conclusion: Robotic Vaginoplasty is easy, duplicable modality in modern world with less morbidity