Canterbury Surgeon a Pioneer

The Christchurch Press, 8 April 2000

Plastic surgeon Peter Walker and his team pioneered a world first, male-to-female surgery, now in its eighth year.

Sex-change surgeons elsewhere commonly fashion a vagina from penile skin and a skin graft from the inner thighs.

But Mr Walker's team, including a urologist and colorectal surgeon in a five-hour laparoscopic operation, have revolutionised the surgery by using the large intestine.

The team adapted a technique invented by a London paediatric surgeon to help young girls born without vaginas, using the caecum and ascending colon.

The Walker team use the appendix end of the intestine, the ascending colon. About 20cm of the 2.4m-long colon is immobilized and inverted 1800 down into the correct anatomical position of the vagina between the bladder and the rectum.

Skin from the shaft of the penis is folded up longitudinally to mimic the labial folds and form the vagina's entrance.

The crowning touch is a clitoris, a tiny nub taken from the erogenous portion of the glans penis along with its own nerve and blood supply that functions as nature intended.

The advantages of using the colon, Mr Walker says, are that it has its own blood supply, is stretchable, and has a small amount of mucus, so it is self-lubricated. The new vagina is "anatomically correct", he says, and hard to distinguish from a born female's.