Alberto Martini1, Eugenio Dattolo2, Jacopo Frizzi2, Donata Villari2, Maria Cristina Paoletti2. 1. Department of Urology, University of Florence, Careggi Hospital, Viale San Luca, 50134, Florence, Italy. a.martini.md@gmail.com. 2. Department of Urology, University of Florence, Careggi Hospital, Viale San Luca, 50134, Florence, Italy.
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.
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.
Authors: Mubashir Shabil Billah; Michael Stifelman; Ravi Munver; Johnson Tsui; Gregory Lovallo; Mutahar Ahmed Journal: Transl Androl Urol Date: 2020-04