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Figure 1. Scrotectomy. (A) an elliptical incision is made around the scrotal skin and extended to the proximal shaft; (B) the wound is re-
approximated in several layers in the midline.

peritoneal vaginoplasty . Although one could opt to use skin grafts or allografts for canal coverage, a
[29]
peritoneal approach minimizes the need for additional external tissue, while remaining both cosmetically
favorable and cost-effective. It is believed that a robotic approach, compared to an open approach for the
peritoneal flap harvest, would enable smaller incisions, less blood loss, and shorter hospitalization, much
[34]
like what has been seen for prostatectomy surgery . PSV is approached by first palpating the perineal body,
which serves as the base of the perineal flap. An incision is then made about 1 cm from the groin crease
bilaterally, extending to the base of the perineal flap [Figure 2A]. Once the vulvar incision is made, the