Vesico-vaginal fistulas are rare in the western world and are usually a complication of gynecologic surgery. We describe in this video our technique of robotic repair of complex vesico-vaginal fistulas by interposition of a pedicled peritoneal flap.
Salient features of the technique are as follow: cystoscopy with bilateral ureteral stenting; placement of a 5 Charr catheter into the fistula brought out through the vagina; posterior longitudinal cystotomy; excision of the fistula; viable tissue between vagina and bladder is found; opening of the vesico-vaginal septum and mobilization of the vaginal flaps to allow transverse tension-free closure; double-layer longitudinal bladder closure to avoid overlapping sutures; interposition of a pedicled peritoneal flap between the two perpendicular suture lines.
Three patients underwent robotic repair of vesico-vaginal fistula by the use of a pedicled peritoneal flap. Mean operative time was 127 minutes. No intraoperative or postoperative complications were encountered. Hospital stay was between two and three days. Catheter was removed at 2 weeks postoperatively. At 10 months we did not observe any fistula recurrence.
Robotic repair of complex vesico-vaginal fistula using a pedicled peritoneal flap can be safely and efficiently performed. It represents a minimally invasive alternative to the standard open repair.
InstitutionSan Giovanni Hospital, Rome, Italy
-
Male to female surgery
Perovic, Sava;
Department of Urology, School of Medicine, University of Belgrade, Serbia
- added über 2 Jahren ago
- Hits: 40457
- Duration: 00:18:25
-
New refinements in male-to-female sex reassignment surgery
Perovic, Sava V.; Djinovic, Rados P.; Milosavljevic, Marko Z.;
Department of Urology, School of Medicine, University of Belgrade, Serbia bSerbian Academy of Sciences and Arts, Belgrade, Serbi
- added über 2 Jahren ago
- Hits: 20963
- Duration: 00:07:44
-
TOT Sling Vaginal Surgery - Transobturator Sling
Moore, R. D.; Miklos, J. R.;
Atlanta Center for Laparoscopic Urogynecology, Alpharetta, Georgia, USA
- added über 2 Jahren ago
- Hits: 17129
-
Intersex masculinizing operation
Perovic, Sava;
Department of Urology, School of Medicine, University of Belgrade, Serbia
- added über 2 Jahren ago
- Hits: 12491
- Duration: 00:18:30
-
Robotic-assisted laparoscopic sacrocolpopexy
Anger, Jennifer; Kim, Ja-Hong; Schulam, Peter;
Dept. of Urology, David Geffen School of Medicine at UCLA, Los Angeles, USA
- added über 2 Jahren ago
- Hits: 11860
-
Vaginoplasty in male transsexuals
Perovic, MD, Sava;
Department of Urology, University of Belgrad, Belgrad, Serbia
- added über 2 Jahren ago
- Hits: 11373
- Duration: 00:07:48
-
One stage reconstruction of the urethra and bladder neck, following severe obstetric trauma (SIU 2010)
Wadie, Bassem;
Urology and Nephrology Center, Mansoura, Egypt
- added about 1 year ago
- Hits: 11258
- Duration: 00:07:57
- ready for iPad/iPhone
20 Videos






















There are no comments available yet.