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Laparoscopic transvesical vesicovaginal fistula repair with the least invasive way:Only three trocars and a limited posterior cystotomy

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Asian Journal of Urology 2020年第4期7卷 351-356页

作者： Stilianos Giannakopoulos Halil Arif Zisis Nastos Apostolos Liapis Christos Kalaitzis stavros touloupidis Department of Urology Democritus University of ThraceAlexandroupolisGreece Endoscopy Unit Democritus University of ThraceAlexandroupolisGreece

Objective:Two conventional approaches for vesicovaginal fistula(VVF)repair are transabdominal repair for supratrigonal VVF and transvaginal approach for low lying *** surgery was introduced to duplicate the surgical steps of the transabdominal approach with reduction in *** report a series of patients treated with a modified laparoscopic technique which includes the use of only three trocars and a limited posterior ***:We retrospectively reviewed the data of eight patients who underwent laparoscopic VVF repair with our standardized technique from January 2015 to April *** cases with a supratrigonal fistula were *** constantly used only three trocars.A limited 2 cm midline posterior cystotomy was performed using ultrasonic energy.A stay suture on a straight needle was passed percutaneously in the abdomen,then on either side of the cystotomy and finally was exteriorized to maintain *** cystotomy was extended downwards to include the fistula *** fistula was dissected circumferentially to raise the bladder and vaginal *** vaginal defect was closed in a transverse fashion and the cystotomy was closed ***:Mean operative time was 17831.6 min and estimated blood loss was 6018.7 *** interposition was performed in six *** intraoperative complications were *** hospital stay was 2.250.89 *** hospitalization two patients experienced postoperative complications(Clavien grade I).Mean follow-up was 20.911.1 months(6.0e39.0 months).All patients remained continent during the follow-up ***:This minimally invasive laparoscopic approach with only three trocars and limited posterior cystotomy provides excellent results with minimum morbidity.

关键词： Laparoscopic Vesicovaginal fistula Transvesical Extravesical Repair

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