Robotic vesico-vaginal fistula repair with no omental flap interposition. Issue 8 (August 2016)

• Record Type: Journal Article
• Authors: Martini, Alberto; Dattolo, Eugenio; Frizzi, Jacopo; Villari, Donata; Paoletti, Maria
• Is Part Of: International urogynecology journal. Volume 27:Issue 8(2016)
• Page Start: 1277
• Page End: 1278
• Publication Date: 2016-08
• Subjects: Vesico-vaginal fistula -- Robotic -- Minimally invasive repair; Urogynecology -- Periodicals; Generative organs, Female -- Diseases -- Periodicals; 616.60082
• DOI: 10.1007/s00192-016-2989-5
• Languages: English
• ISSNs: 0937-3462

Abstract

Abstract Introduction and hypothesis A vesico-vaginal fistula (VVF) is a fistulous tract that connects bladder and vagina, causing urine leakage via the vagina. In the developed world, iatrogenic postoperative VVF is the most common case. Classically, when treating a VVF via the abdominal route, an abdominal flap is mobilized and interposed between the bladder and the vagina. Methods In our video, we describe a robotic VVF repair technique with no omental flap interpositioning for a vaginal vault-located fistula. Results Duration of surgery was 95 min, estimated blood loss was <50 ml. The postoperative course was uneventful. At the 6-month follow-up, which included clinical and cystographic examinations, the patient had not experienced any recurrence. Conclusion In our opinion, a two-layered suturing technique using two semi-continuous sutures for vaginal closure and perpendicular interrupted stitches for bladder closure does not require omental flap mobilization, reducing operating time and possible complications related to accidental peritoneal injuries.