Robotic Repair of Vesicovaginal Fistula: Our Experience

Abstract

Introduction: Vesicovaginal fistula (VVF) may be attributed to iatrogenic, obstetric, or neoplastic etiologies. Although a wide range of repairs exist, laparoscopic repair has been favored for superior morbidity profile with appreciable outcome.We present our experience of VVF repair in different circumstances. The video demonstrates the conduction of this procedure following vaginal mesh erosion.

Methods: All patients were evaluated with detailed history, presenting complaints, details of comorbidities, and blood profile. Imaging was carried out preoperatively to delineate the pathology. All patients underwent cystoscopy and vaginoscopy prior to definitive reconstruction. Repair was undertaken following O Connor s technique: transperitoneal transvesical approach for VVFs.2 A vascularized omental flap was interposed between the vagina and bladder, followed by vesical closure. Postprocedure patients were allowed oral intake once comfortable, and drain and catheter removal was conducted as merited. Postoperative parameters were recorded. Postoperatively, patients were followed up periodically and follow-up imaging was conducted at 6 months postprocedure.