Treatment of Colovesical Fistulas by Laparoscopic Surgery: Report of Five Cases

Abstract

Operative laparoscopy was performed in 5 patients with colovesical fistulas resulting from complicated diverticular disease. In all cases the clinical picture was characterized by pneumaturia and signs of diverticular disease of the sigmoid. The diagnosis was established by barium or water-soluble contrast enema, computed tomography and cystoscopy. A laparoscopic approach, based on our experience in laparoscopic colon surgery, was used in all our cases. One-stage excision of the fistula and sigmoid resection was performed laparoscopically without conversion, using an Endo-GIA^TM device. Postoperatively, no major complications were observed and full oral feeding was initiated on the third postoperative day. The mean total hospital stay was 13 days. We believe that ‘one-stage’ excision of colovesical fistulas combined with simultaneous colon resection is feasible laparoscopically, but the training and experience of the surgeon are primordial for the success of this method.