A Vaginal Mucosal Pedicle Flap Technique for Repair of Rectovaginal Fistula in Mares

Abstract

Tension-free closure of RVF can be achieved by rotating a pedicle flap of vaginal mucosal tissue without undue wound tension, and should be considered as an alternative to conventional appositional techniques.

Surgical correction of rectovaginal fistula in mares and subsequent fertility

“…With appropriate instrumentation surgeons have excellent exposure of the surgical site. Numerous techniques for the surgical management of RVF have been described in the literature according to personal preference of the surgeon 1–3,5–12 . Briefly, these techniques may be subdivided into conversion of a RVF into a third‐degree perineal laceration and its subsequent repair, 2,3,5,7 transection of the perineal body, 8,12 direct repair through the vestibule, 9 direct repair through the anus 6,10 and more recently, the use of a vaginal mucosal pedicle flap 11 …”

“…The efficacy of the various surgical techniques can be judged according to the ability of the mare to conceive post surgery, the incidence of failure of the repair and the incidence of re‐injury during subsequent foalings. In the literature regarding RVF repair, many reports describe only small (3–6) numbers of mares 7,9–12 . Additionally, in some reports the results of repair of third‐degree perineal lacerations and RVF are combined, making the specific success rate of repairing RVF unclear 2 .…”

“…Numerous techniques for the surgical management of RVF have been described in the literature according to personal preference of the surgeon. [1][2][3][5][6][7][8][9][10][11][12] Briefly, these techniques may be subdivided into conversion of a RVF into a third-degree perineal laceration and its subsequent repair, 2,3,5,7 transection of the perineal body, 8,12 direct repair through the vestibule, 9 direct repair through the anus 6,10 and more recently, the use of a vaginal mucosal pedicle flap. 11 The efficacy of the various surgical techniques can be judged according to the ability of the mare to conceive post surgery, the incidence of failure of the repair and the incidence of re-injury during subsequent foalings.…”

“…In the literature regarding RVF repair, many reports describe only small (3-6) numbers of mares. 7,[9][10][11][12] Additionally, in some reports the results of repair of third-degree perineal lacerations and RVF are combined, making the specific success rate of repairing RVF unclear. 2 Even more difficult is determining specific results of postoperative fertility when comparing a large number of retrospective studies, because a consistent method of measuring a successful outcome has not been used.…”

Rectovaginal Fistula Repair

“…2 As long as principles of flap develop- ment are respected, this technique avoids excessive tension on wound closure and minimizes swelling and pain after surgery.…”