First in Surat : Doctors successfully perform Sigmoid Vaginoplasty to transform transgender male into transwoman

Surat: Vikas (name changed) has become the first transgender male to successfully undergo the Male-to-Female (MtF) gender reassignment surgery procedure that transforms natal male genitals into a functional, aesthetically pleasing vagina.

Thanks to the team of three doctors in the diamond city, who for the first time, performed Sigmoid Vaginoplasty—sigmoid vaginal plastic surgery—on a transgender male and transformed his natal genitals into a vagina. The surgery was performed by cosmetic plastic surgeon, Dr. Ashutosh Shah, reconstructive urologist Rishi Grover, and GI surgeon Dr. Dhaval Mangukia.

Dr Ashutosh Shah


Sigmoid vaginal plastic surgery was performed for the first time in Surat.

Transgender surgery has been completed for the first time in Surat city.  This surgery has opened many new avenues for the medical field, as well as it is a huge achievement for the medical team of Surat city.  Three doctors of the city together have made this difficult surgery successful.  The surgery was performed by cosmetic plastic surgeon Dr. Ashutosh Shah, reconstructive urologist Dr. Rishi Grover, and GI surgeon Dr. Dhaval Mangukia.

Talking with TBT, Dr. Ashutosh Shah, the cosmetic plastic surgeon said, “Transgenders are caught in the confusion between their body and mind.  The patient’s mind refuses to accept its gender.  There comes a time in his life when he does not want to live with this condition. During this time, his body and mind are prepared for surgery. In many cases, it is seen that the parents of such patients start psychiatric treatment in their childhood, although it is not a mental illness.”

Dr. Rishi Grover, reconstructive urosurgeon, says, “People in our society believe transgenders suffer from the disorder, but it is not the disorder. Instead, we call it gender dysphoria and not the gender disorder”

Dr Rishi Grover


Who is called Transgender?

Dr. Ashutosh Shah explains that a transgender is a person whose body is that of a man and he considers himself to be a woman with his mind or vice-a-versa. Such people refuse to accept and that they consider themselves as men and women as per their transgender minds. Such people are called transgender.  There is a constant internal battle going on in the minds of transgenders for their identity.  Transgenders have to fight with themselves and society in their daily lives.  They constantly have to fight for their real identity. Only surgery is the best option for such transgenders.

What is the difference between transgender and eunuch?

Reconstructive urosurgeon, Dr. Rishi Grover explains the Kinnar or Eunuch is neither male nor female.  They are placed in the category of the third gender.  Even legally, they have been given the title of the third gender.  On the other hand, transgender is either a woman or a man, who is trapped in the body opposite to his mind.  However, by changing your body through surgery, you can get the desired gender.

Is there any reason behind a person becoming transgender?

Doctors say there is no specific reason found behind this, but changes could be visible after the birth of a person and their body language.  Sometimes this happens due to genetic reasons, and due to the surrounding environment, as many children mimic their mothers, how they walk and talk.  There could be many such reasons, but no specific reason has been found so far.

What other changes take place in the patient before the surgery

Before surgery, the external appearance of the patient has to be changed.  For this, the patient’s hair is transplanted, along with voice surgery, in which a man’s Adam’s apple is removed and the voice is by changing the vocal cords.  The patient’s chest and beard hairs are then removed through laser removal.  Later, the treatment of his nose, which is called rhinoplasty treatment, is also done, because the structure of a man’s nose is slightly higher, so surgery is performed to make him look like a woman.  After that their hormone therapy is also done, in which they are given hormones of the opposite sex for the mental and physical changes. Dr. Ashutosh says that all these facilities are available in the Elegance Clinic of Surat.

Dr Dhaval Mangukia


When does the surgery start, and how is it done?

“Before starting this surgery, doctors hold personal sessions to know the patient completely.  They are given psychiatrists and psychologists who try to know their complete details and try to understand them, then they give their opinion whether this surgery will benefit them or not.  This process lasts for about a year, after which they are given a certificate of gender dysphoria and the further process of his surgery begins”, said cosmetic plastic surgeon Dr. Ashutosh Shah.

The surgery starts with plastic surgery first. Plastic surgery is performed in two stages, first comes the top surgery and the second bottom surgery.  Breast surgery is done in top surgery, while genital surgery is done in bottom surgery.  First, a psychiatrist’s opinion and patient’s affidavit are taken, then top surgery is performed by a plastic surgeon.  During top surgery, if the patient wants to become a female, then breast surgery is done in which breast implant is done in their chest area.  Or if a patient wants to become a man, then through surgery, the chest is made by removing the breast.  After which they have to live in society wearing the clothes of the opposite sex for a year.  After the top surgery, the patient has to live life with the changes in the body to adjust to society and surroundings.  The top surgery can be reversed, but the bottom surgery is completely irreversible.  It takes about two years in this whole process so that they can live as the opposite sex and make their decision more firmly.  Many such people are happy only with top surgery and live their life like this.  After all these procedures, when everything goes well, then again after taking the opinion of the psychiatrist, bottom surgery is done, in which surgery of their genitals is performed. In bottom surgery, they are also made vaginal passages so that they can go ahead and lead their normal sex lives.

What is Sigmoid Vaginoplasty?

In most male-to-female (MtF) transgender bottom surgeries, the foreskin of their penis is cut to create a vaginal passage, but in this, the height of the vaginal passage is reduced and over time it shrinks and remains dry from the inside. However, Rectosigmoid Vaginoplasty a.k.a Sigmoid Colon Vaginoplasty uses a section of the sigmoid colon to create the vaginal lining. It is an intrusive procedure in which the intra-abdominal cavity must be entered via a low transverse abdominal incision (like Caesarean section incision in biological females). However, Rectosigmoid Vaginoplasty results in a well-proportioned, self-lubricating vagina, which has less risk of losing vaginal depth. Furthermore, this segment of the colon is thick-walled and large in diameter, and flexible.

Dr. Rishi Grover and Dr. Dhaval Mangukhia GI surgeon made a sigmoid colon section of approximately 7-8 inches in length and harvested a pedicle flap, with the neurovascular bundle, through an abdominal incision, then the rest of the colon is reconnected, so that their toilet passage can function normally.  Dr. Ashutosh removed the patient’s penis and male genitals and converted them externally into female genitals.  So that his whole look becomes like a woman.  Since his breast implant surgery was already done by Dr. Ashutosh, now he can completely change his identity and become a transwoman.


Dr. Dhaval Mangukia said that he completed this process by making a cut in the patient’s stomach.  With the advancement of technology, this procedure can be done more easily in the future through laparoscopy surgery.  Laparoscopy surgery will not require any cut in the patient’s abdomen, and that it can be done with a small hole, which will give the same result as before.  Due to this, the patient will not suffer much and they will not have any marks on their stomach.

How doctors prepared themselves for surgery

This surgery is being done for the first time in Surat.  Dr. Rishi Grover said, “It was a mental obstacle which we had to overcome. At the same time, we prepared ourselves mentally because it is a principle of the medical field that ‘first do no harm because the patient trust us and we have to take his responsibility for doing the surgery successfully. This process requires the entire team and their coordination.  This surgery is done after careful consideration so that the patient gets less pain and more benefits.  For which we made this surgery successful with all our mental and physical hard work.”

Dr. Dhaval Mangukhia says, “The patient will get a new life, he was yearning for after the surgery is done. It gives us a great amount of happiness and joy when we see the smiling face of our patients.”

Doctors message to the general public

There is no harm or any danger to society due to transgenders. Adopt them in society and support them.  It is the moral duty of the government to frame a law in the country so that transgenders can lead a normal life.  They just want basic human rights to which every human being is entitled.  If they want to live their life in their way, then they should get the full right to live in society and they should get all the basic human rights to which they are entitled.