Ascending Colon Method with Drs. Walker, Perry and Mark

by Terry

[this report on the procedure done by E. Peter Walker and team was written in 2003]

Few of us are aware that a unique method for sex reassignment surgery exists in the hands of three talented surgeons in Christchurch, New Zealand. I had accidentally stumbled upon their existence while surfing websites for referrals. I had initially chosen my SRS surgeon at the beginning of my transition but changed my mind after I read about the NZ surgeons’ technique.

The name of the method is the Ascending Colon Method. Essentially, the colorectal surgeon, Dr. Richard E. Perry, removes approximately 8 inches of the ascending colon just above the appendix and reattaches the two severed ends of the intestinal tract. The removed ascending colon section, with its blood supply still intact, is rotated 180 degrees and moved toward its new position to become the vaginal lining. All of this is done by laparoscopy. Next, the urologist, Dr. Stephen D. Mark, creates a vaginal tunnel near the perineum, shortens the urethral tube and positions it in a female configuration. The vaginal lining is then positioned and attached to its proper location at the opening of the vaginal tunnel. Lastly, the plastic surgeon, Dr. E. Peter Walker, fashions the external genitalia. All three surgeons are working together and helping each other during the entire surgery. The neo-vagina is then packed with dressing and the patient is returned to her room for rest and recovery. This is a crude explanation but fairly accurate.

There are several advantages to this surgery. First, there is a quick recovery period with this method. By the second day post-op, I was encouraged to try to walk around the ward. I found that once I started, I didn’t want to stop. I ended up making three circuits around the ward and only stopped because the nurse needed to return to her duties. Also on the second day, I started back eating soft foods, and then switching to solid foods the next day. I was released from the hospital on the fourth day by my request as I felt I was strong enough to return to my motel. Pain was very minimal. Second, the neo-vagina is self-cleaning and self-lubricating. The section of the ascending colon secretes a small amount of mucus as part of its design. The downside with this is the mucus tends to have an undesirable odor to it so you need to replace your panty liner often. Shortly after the surgery, your discharge tends to be fairly heavy but tapers off within a few weeks. Third, the vaginal lining is distensible and doesn’t shrink. However, you need to perform the required dilation or the opening will try to close. Your body sees the opening as a wound and tries to close it unless to you maintain the opening by using the stents provided to you prior to your discharge from the hospital. You need to be using the largest stent by the third month, at which time the vaginal opening is not as pliant in order to increase its diameter. I found that I was able to successfully insert the largest stent in about two months after the surgery and maintaining the diameter of the vaginal opening to be fairly routine afterwards.

My experience with the personnel involved with my surgery was very good. Dr. Walker was extremely friendly throughout the entire process. Drs. Mark and Perry were very professional but somewhat distant at the consultations. However, when visiting me at the hospital following the surgery, they both were quite friendly and genuinely compassionate, ensuring that I was comfortable and healing nicely. The hospital staff was top-notch and extremely nice. I had a private nurse for approximately twelve hours following the surgery. Afterwards, the regular nurses checked in on me regularly and even took the time to chat with me for an appreciable amount of time. That was important when I came to New Zealand alone.

New Zealand is a lovely country with the South Island being quite diversified in its terrain. Christchurch is on the eastern coast while the Southern Alps runs down the South Island only. If you are a skier, there are plenty of ski resorts only an hour and a half away. However, don’t take your own equipment. It is MUCH cheaper to rent good quality equipment at the resorts or ski and snowboard shops in Christchurch than to bring your own. Trust me on that one! There are other things to do that are nearby so don’t worry about being bored. The New Zealanders were very friendly and treated me with respect. I have the highest regard for them and I look forward to return again for a vacation.

The only thing I didn’t really enjoy is the long flights between Los Angeles and Auckland. The flight attendants on Air New Zealand made sure your flight is as enjoyable as possible but they can do nothing to reduce the flight time. I suggest requesting an isle seat and taking frequent strolls throughout the flights. Bring reading material with you as there can be dead times without a movie showing.

Finally, the cost of the surgery is comparable to those in the United States. The cost of my surgery was just over $ 17,000, excluding travel, room accommodations, meals, and miscellaneous and sundry things. In total, I ended up spending over $ 20,000 but it was worth every penny of it. Another thing to keep in mind is the amount of time required to be in New Zealand. I was required to arrive approximately two weeks prior to surgery and remain approximately four weeks after the surgery. That is a long time to be away from work and family but it is required. The first two weeks are required for consultations and having blood drawn and stored in case a transfusion is required during the surgery. The last four weeks are for check-ups and follow-ups. One important feature you need to keep in mind is the surgeons require a two-year real life test instead of the minimum one-year RLT as set forth in the Standards of Care. They are not flexible on this requirement so be prepared to do your two-year sentence. Also, my attempt to schedule my surgery was a test of patience as it took a little over a year to procure a surgery date. They only perform about twelve SRS per year so the sooner you get scheduled, the better.

I would highly recommend this surgery utilizing these surgeons for your SRS. The experience is like none other and I’m left with fond memories exclusive of the life-altering surgery.

Contact information:

Address: Block 1 Milford Chambers, 245 Papanui Road, Christchurch 8001, New Zealand

Phone: 64-3-355 9089

Fax: 64-3-355 9088


Email: or through contact form

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