Robotic uterine-sparing vesicovaginal fistula repair.
Int Urogynecol J
; 29(12): 1845-1847, 2018 Dec.
Article
in En
| MEDLINE
| ID: mdl-30069726
ABSTRACT
INTRODUCTION AND HYPOTHESIS:
The objective was to describe a technique for the robotic repair of complex vesicovaginal fistula (VVF) with uterine preservation.METHODS:
From 2015 to 2017, two patients underwent the procedure. Following placement of the patient in the lithotomy position, catheterization of the fistulous tract and laparoscopic omental harvesting is performed. Then, the robotic system is docked. A transverse incision was made in the peritoneum above the uterus was made to provide access to the bladder, the uterus is mobilized, and a cystotomy is performed to identify the structures. Subsequently, the cystotomy is extended toward the fistulous tract, the plane between the organs is dissected to proceed with the vaginal closure, the vagina is closed, the omental flap is interposed, and the bladder is closed.RESULTS:
Mean operative time (OT) was 219 min. Mean estimated blood loss (EBL) was 75 ml. One of the patients had an intraoperative cervix canal injury that was identified and repaired. The postoperative course was uneventful, and the mean length of hospital stay (LOS) was 1 day. A mean follow-up of 17 (±9.89) months showed no recurrence at cystoscopy or imaging evaluation.CONCLUSIONS:
Uterine-sparing VVF repair is feasible and safe. More studies are needed to assess equivalence compared with other procedures.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Gynecologic Surgical Procedures
/
Vesicovaginal Fistula
/
Robotic Surgical Procedures
Type of study:
Prognostic_studies
Limits:
Female
/
Humans
Language:
En
Journal:
Int Urogynecol J
Journal subject:
GINECOLOGIA
/
UROLOGIA
Year:
2018
Document type:
Article
Affiliation country:
United States