International Urogynecology Journal

, Volume 27, Issue 8, pp 1277–1278 | Cite as

Robotic vesico-vaginal fistula repair with no omental flap interposition

  • Alberto MartiniEmail author
  • Eugenio Dattolo
  • Jacopo Frizzi
  • Donata Villari
  • Maria Cristina Paoletti
IUJ Video


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.


Vesico-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.

Supplementary material


(MP4 90608 kb)


  1. 1.
    Einarsson JI, Hibner M, Advincula AP (2011) Side docking: an alternative docking method for gynecologic robotic surgery. Rev Obstet Gynecol 4:123–125PubMedPubMedCentralGoogle Scholar
  2. 2.
    Miklos JR, Moore RD, Chinthakanan O (2015) Laparoscopic and robotic-assisted vesicovaginal fistula repair: a systematic review of the literature. J Minim Invasive Gynecol 22:727–736CrossRefPubMedGoogle Scholar
  3. 3.
    Miklos JR, Moore RD (2015) Laparoscopic extravesical vesicovaginal fistula repair: our technique and 15-years experience. Int Urogynecol J 26:441–446CrossRefPubMedGoogle Scholar
  4. 4.
    Dutto L, O’Reilly B (2013) Robotic repair of vesico-vaginal fistula with perisigmoid fat flap interposition: state of the art for a challenging case? Int Urogynecol J 24:2029–2030CrossRefPubMedGoogle Scholar
  5. 5.
    Ezzat M, Ezzat MM, Tran VQ, Aboseif SR (2009) Repair of giant vesicovaginal fistulas. J Urol 181:1184–1188CrossRefPubMedGoogle Scholar

Copyright information

© The International Urogynecological Association 2016

Authors and Affiliations

  1. 1.Department of UrologyUniversity of Florence, Careggi HospitalFlorenceItaly

Personalised recommendations