Early laparoscopic repair for supratrigonal vesicovaginal fistula

Nagraj, H. K.; Kishore, TA; Nagalaksmi, S.

doi:10.1007/s00192-006-0232-5

Cited by 35 publications

(15 citation statements)

References 11 publications

(14 reference statements)

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“…In these patients, there had been adequate quality tissue for the repair, and all had a successful outcome. There have been reports of successful repair by laparoscopic techniques within 4 weeks following injury [19][20][21].…”

mentioning

confidence: 99%

Laparoscopic Vesicovaginal Fistula Repair with Limited Cystotomy: A Rewarding Treatment Option

Ghosh

Biswal

Bera

et al. 2015

J Obstet Gynecol India

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mentioning

confidence: 99%

Laparoscopic Vesicovaginal Fistula Repair with Limited Cystotomy: A Rewarding Treatment Option

Ghosh

Biswal

Bera

et al. 2015

J Obstet Gynecol India

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“…[20][21][22] In our series, four of eight (50%) patients had previously undergone unsuccessful open surgery to correct the VVF; this made fistulous tract recognition more difficult because of excessive tissue scarring. We had one conversion (11%) and one failure (12.5%) in the laparoscopic repair of VVF.…”

Section: Discussionmentioning

confidence: 86%

Laparoscopic Management of Iatrogenic Lesions

Abreu

Tanaka²,

Abreu³

et al. 2008

Journal of Endourology

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Purpose: To present our series of patients who underwent laparoscopic correction of iatrogenic lesions and a review of the literature. Patients and Methods:We evaluated 23 patients who underwent laparoscopic correction of iatrogenic lesions.Thirteen patients had open surgery, 6 had an endoscopic procedure, and 4 had a laparoscopic approach as the first surgical procedure. Vesicovaginal fistulas (VVF) developed in seven patients after open abdominal hysterectomies, and 1 patient presented with a VVF after ureterolithotripsy. A urethral cutaneous fistula developed in one patient after a laparoscopic resection of endometriosis nodules, and 1 patient presented with a ureterovaginal fistula after a perineoplasty. Three patients presented with encrusted ureteral stents after ureterolithotripsy. Ureteral stenosis developed in seven patients: three after open abdominal surgery, three after ureteroscopy, and one after pyeloplasty. One patient had a ureteral injury during laparoscopic partial nephrectomy, and two patients had bowel injuries after a tension-free vaginal tape procedure and a laparoscopic radical prostatectomy. Results: All patients underwent laparoscopic correction of the iatrogenic injuries. One patient had an early recurrence of a VVF, and one patient had a recurrence of a ureteral stenosis. There was one conversion to open surgery because of technical difficulties and one major bleeding event that necessitated blood transfusion. A lower limb compartmental syndrome developed in one patient. Conclusion: Despite the small number of patients and different types of surgeries performed, laparoscopic management of iatrogenic lesions seems to be feasible and safe in experienced hands. Its precise role in the management of this stressful condition still needs to be determined. 1279

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“…Nevertheless, the approach chosen should be that with which the surgeon is most comfortable (5,6) Laparoscopic VVF repair by different approaches has been described. Nezhat et al (7) were the first to report the laparoscopic retrovesical approach in 1994, which decreases the morbidity of the abdominal approach with similar success rates that range from 86% to 100% and minimal surgical trauma, allowing for more rapid convalescence (8,(10)(11)(12)(13)(14)(15)(16). Sotelo et al (8) reported an approach in which the bladder is first intentionally opened, accurately leading to the fistulous tract without requiring additional vaginal incisions or further dissection of the vesicovaginal space.…”

Section: Discussionmentioning

confidence: 99%

“…Once the fistula is identified, the vesicovaginal space is dissected to separate the structures; the importance of this technique lies in the intentional cystotomy for localizing the tract. The laparoscopic approach is primarily associated with similar success rates, minimal surgical trauma and reduced morbidity, allowing for more rapid convalescence (4,8,(10)(11)(12)(13)(14)(15)(16). Despite initial enthusiasm, laparoscopy has not gained popularity, most likely because laparoscopic VVF dissection and intracorporeal suturing are technically challenging.…”

Section: Introductionmentioning

confidence: 99%

Robotic repair of vesicovaginal fistulae with the transperitoneal-transvaginal approach: A case series

et al. 2014

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ARTICLE INFO ______________________________________________________________ ______________________Objective: To describe a novel technique of repairing the VVF using the transperitoneal-transvaginal approach. Materials and Methods:From June 2011 to October 2013, four patients with symptoms of urine leakage in the vagina underwent robotic repair of VVF with the transperitoneal-transvaginal approach. Cystoscopy revealed the fistula opening on the bladder. A ureteral stent was placed through the fistulous tract. After trocar placement, the omental flap was prepared and mobilized robotically. The vagina was identified and incised. The fistulous tract was excised. Cystorrhaphy was performed in two layers in an interrupted fashion. The vaginal opening was closed with running stitches. The omentum was interposed and anchored between the bladder and vagina. Finally, the ureteral catheters were removed in case they have been placed, and an 18 Fr urethral catheter was removed on the 14th postoperative day. Results: The mean age was 46 years (range: 41 to 52 years). The mean fistula diameter was 1.5 cm (range 0.3 to 2 cm). The mean operative time was 117.5 min (range: 100 to 150 min). The estimated blood loss was 100 mL (range: 50 to 150 mL). The mean hospital stay was 1.75 days (range: 1 to 3 days). The mean Foley catheter duration was 15.75 days (range: 10 to 25 days). There was no evidence of recurrence in any of the cases. Conclusions:The robot-assisted laparoscopic transperitoneal transvaginal approach for VVF is a feasible procedure when the fistula tract is identified by first intentionally opening the vagina, thereby minimizing the bladder incision and with low morbidity.

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Early laparoscopic repair for supratrigonal vesicovaginal fistula

Abstract: Laparoscopic repair of supratrigonal vesicovaginal fistula is less morbid and equally effective compared to open repair. This approach is advisable when transvaginal repair is difficult.

Cited by 35 publications

References 11 publications

Laparoscopic Vesicovaginal Fistula Repair with Limited Cystotomy: A Rewarding Treatment Option

Laparoscopic Vesicovaginal Fistula Repair with Limited Cystotomy: A Rewarding Treatment Option

Laparoscopic Management of Iatrogenic Lesions

Robotic repair of vesicovaginal fistulae with the transperitoneal-transvaginal approach: A case series

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