Laparoscopic and Robotic-assisted Vesicovaginal Fistula Repair: A Systematic Review of the Literature

Miklos, John R.; Moore, Robert D.; Chinthakanan, Orawee

doi:10.1016/j.jmig.2015.03.001

Cited by 77 publications

(73 citation statements)

References 51 publications

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“…Over the last two decades a number of case reports and series have been published demonstrating good success rates of laparoscopic/robotic VVF repairs. These have been summarized in a relatively recent systematic review of 44 studies [16]. Owing to the significant heterogeneity of these reports, there is significant variation in outcomes with mean length of stay ranging from 1 to 8 days, operative time from 70 to 347 mins and success rate from 80% to 100%.…”

Section: Limitationsmentioning

confidence: 99%

The cost effectiveness of vaginal versus abdominal repair of vesicovaginal fistulae

et al. 2019

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Introduction and hypothesis The objective was to assess the comparative provider costs of vaginal and open abdominal repair of vesicovaginal fistula (VVF) and to determine the most cost-effective means of managing VVF. Methods A prospectively acquired database of all women undergoing VVF repair by a single surgeon between 2007 and 2015 was retrospectively reviewed to determine operating time, perioperative complications, inpatient stay and 30-day readmissions. The success and cost of the VVF repair were identified. Statistical analysis was by unpaired t test, Chi-squared test and Mann-Whitney U test. Results Forty-seven consecutive women of mean age 51 years (range 21-88) undergoing a first attempt at VVF repair at our institution were included; 32(68%) had vaginal repair with Martius fat pad interposition and 15 (32%) had open abdominal repair with omental interposition. There were no perioperative complications or 30-day readmissions in either group. Mean operative time was longer for open abdominal (223.4 min) than vaginal repair (196.9 min). Median inpatient stay was longer for an open abdominal (8 days) than for a vaginal approach (4 days). Successful anatomical closure was achieved in 91% of vaginal and 86% of open abdominal repairs at first attempt, and in 100% after second repair, where required. Mean/median costs for an abdominal repair were significantly higher, at £4,608.69/£4,169.20 than for vaginal repair at £3,381.50/£3,009.24 (P < 0.05). Conclusions Vesicovaginal fistulae were successfully repaired in 89% of cases at first attempt. The success rate did not differ between approaches. Vaginal repair is significantly more cost-effective than abdominal repair owing to the shorter operative time and length of stay.

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Section: Limitationsmentioning

confidence: 99%

The cost effectiveness of vaginal versus abdominal repair of vesicovaginal fistulae

et al. 2019

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“…Außerdem wurden 15 % der Patientinnen in einem alleinigen laparoskopischen oder robotorassistierten Eingriff versorgt [22]. Dabei weisen Miklos et al (2015) [35] für den laparoskopischen bzw. roboterassistierten Eingriff ähnliche Erfolgsraten für den transvesikalen (95.89 %) und extravesikalen Ansatz (98.04 %) nach [22].…”

Section: Therapie Der Vesikovaginalen Fistelunclassified

Diagnostik und Therapie vesikovaginaler und ureterovaginaler Fisteln

2018

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“…The vascularized pedicle serves as a barrier and theoretically introduces vascularity to the area. However, in one reported series of patients undergoing repair of recurrent VVFs, where an omental interposition graft had been used, the authors noted a lack of neovascularity in the area of the primary fistula repair and in many cases the omental graft itself was missing [ 7 ]. This raises some question as to how effective the standard omental graft actually functions in this setting, and this could at least partially explain some of the poor outcomes seen with open surgical repair of irradiated VVFs.…”

Section: Discussionmentioning

confidence: 99%

“…There are limited reports of using laparoscopic and robotic techniques to repair complex VVFs in general, and there are no reported cases of robotic VVF repair in an irradiated field [ 5 – 7 ]. In fact, there is only one single case of laparoscopic VVF repair in an irradiated field [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Robotic repair of a vesicovaginal fistula in an irradiated field using a dehydrated amniotic allograft as an interposition patch

Price

2015

J Robotic Surg

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We report the case of a 66 year old female with a supratrigonal vesicovaginal fistula (VVF) that developed after undergoing radical hysterectomy, chemotherapy and pelvic radiation therapy for advanced cervical cancer. VVF repairs in an irradiated field are known to be complicated procedures with significant morbidity and a high rate of failure due to the effect of radiation. Amniotic membranes have been demonstrated to improve healing rates in difficult to heal wounds. To decrease morbidity a minimally invasive robotic procedure was performed and a dehydrated amniotic allograft patch was used to augment tissue healing. The VVF was repaired using the da Vinci Surgical System and the amniotic membrane was used as an interposition patch over the repair. There were no operative or postoperative complications and the patient was discharged home on postoperative day one. A cystogram performed 3 weeks postoperatively demonstrated a healed fistula. Follow-up at 5 months revealed no incontinence. This is the first reported case of a robotic VVF repair performed in an irradiated pelvis and the first use of an amniotic membrane allograft in the repair a VVF.Electronic supplementary materialThe online version of this article (doi:10.1007/s11701-015-0546-8) contains supplementary material, which is available to authorized users.

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Laparoscopic and Robotic-assisted Vesicovaginal Fistula Repair: A Systematic Review of the Literature

Cited by 77 publications

References 51 publications

The cost effectiveness of vaginal versus abdominal repair of vesicovaginal fistulae

The cost effectiveness of vaginal versus abdominal repair of vesicovaginal fistulae

Diagnostik und Therapie vesikovaginaler und ureterovaginaler Fisteln

Robotic repair of a vesicovaginal fistula in an irradiated field using a dehydrated amniotic allograft as an interposition patch

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