Purpose
Vesicovaginal fistula (VVF) refers to an abnormal communication between the bladder and vagina, leading to uncontrolled leakage of urine from the vagina. This study aimed to assess the efficacy and safety of robot-assisted laparoscopic VVF repair with a "rainbow-shaped" peritoneal flap.
Methods
A retrospective analysis was conducted on 15 patients who underwent robot-assisted VVF repair from July 2021 to March 2023 in Peking University First Hospital. The patient cohort included 1 patient who had undergone abdominal hysterectomy, 11 patients who had laparoscopic hysterectomy, 1 patient who had cervical conization, and 2 adolescents with residual intravaginal foreign bodies.
Results
7 had a history of failed VVF repair, while 8 underwent primary repair. The mean operative time was 137 (range: 92–182) minutes, and the mean hospital stay was 4.9 (range: 4.3–5.5) days. Surgical blood loss was minimal, averaging 14 (range: 6–22) ml. The fistula was located supratrigonal in 14 patients and in the triangle area in 1 patient. In the vagina, the fistula was situated at the stump in 12 patients and at the anterior wall or cervix in 3 patients. All procedures were successfully completed without the need for open conversion. All 15 patients achieved successful repair, with no complications reported during the mean follow-up period of 7.8 months.
Conclusion
Robot-assisted laparoscopic repair with a "rainbow-shaped" peritoneal flap for VVF is an effective, safe, and highly successful technique.