Robotic vesico-vaginal fistula repair with no omental flap interposition
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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.
In our video, we describe a robotic VVF repair technique with no omental flap interpositioning for a vaginal vault-located fistula.
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.
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.
KeywordsVesico-vaginal fistula Robotic Minimally invasive repair
Compliance with ethical standards
Conflicts of interest
Written informed consent was obtained from the patient for publication of this video article and any accompanying images.
(MP4 90608 kb)