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Robotic repair of vesicovaginal fistulae with the transperitoneal-transvaginal approach: a case series.
Bragayrac, Luciano A Nunez; Azhar, Raed A; Fernandez, Golena; Cabrera, Marino; Saenz, Eric; Machuca, Victor; Andrade, Robert de; Carmona, Oswaldo; Sotelo, Rene.
Afiliação
  • Bragayrac LA; Robotic and Minimally Invasive Surgery Center, Instituto Médico La Floresta Caracas - Venezuela.
  • Azhar RA; University of Southern California Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
  • Fernandez G; Robotic and Minimally Invasive Surgery Center, Instituto Médico La Floresta Caracas - Venezuela.
  • Cabrera M; Robotic and Minimally Invasive Surgery Center, Instituto Médico La Floresta Caracas - Venezuela.
  • Saenz E; Robotic and Minimally Invasive Surgery Center, Instituto Médico La Floresta Caracas - Venezuela.
  • Machuca V; Robotic and Minimally Invasive Surgery Center, Instituto Médico La Floresta Caracas - Venezuela.
  • Andrade Rd; Robotic and Minimally Invasive Surgery Center, Instituto Médico La Floresta Caracas - Venezuela.
  • Carmona O; Robotic and Minimally Invasive Surgery Center, Instituto Médico La Floresta Caracas - Venezuela.
  • Sotelo R; Robotic and Minimally Invasive Surgery Center, Instituto Médico La Floresta Caracas - Venezuela.
Int Braz J Urol ; 40(6): 810-5, 2014.
Article em En | MEDLINE | ID: mdl-25615249
OBJECTIVE: To describe a novel technique of repairing the VVF using the transperitoneal-transvaginal approach. MATERIALS AND METHODS: From June 2011 to October 2013, four patients with symptoms of urine leakage in the vagina underwent robotic repair of VVF with the transperitoneal-transvaginal approach. Cystoscopy revealed the fistula opening on the bladder. A ureteral stent was placed through the fistulous tract. After trocar placement, the omental flap was prepared and mobilized robotically. The vagina was identified and incised. The fistulous tract was excised. Cystorrhaphy was performed in two layers in an interrupted fashion. The vaginal opening was closed with running stitches. The omentum was interposed and anchored between the bladder and vagina. Finally, the ureteral catheters were removed in case they have been placed, and an 18 Fr urethral catheter was removed on the 14th postoperative day. RESULTS: The mean age was 46 years (range: 41 to 52 years). The mean fistula diameter was 1.5 cm (range 0.3 to 2 cm). The mean operative time was 117.5 min (range: 100 to 150 min). The estimated blood loss was 100 mL (range: 50 to 150 mL). The mean hospital stay was 1.75 days (range: 1 to 3 days). The mean Foley catheter duration was 15.75 days (range: 10 to 25 days). There was no evidence of recurrence in any of the cases. CONCLUSIONS: The robot-assisted laparoscopic transperitoneal transvaginal approach for VVF is a feasible procedure when the fistula tract is identified by first intentionally opening the vagina, thereby minimizing the bladder incision and with low morbidity.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fístula Vesicovaginal / Laparoscopia / Procedimentos Cirúrgicos Robóticos Tipo de estudo: Prognostic_studies Limite: Adult / Female / Humans / Middle aged Idioma: En Revista: Int Braz J Urol Assunto da revista: UROLOGIA Ano de publicação: 2014 Tipo de documento: Article País de publicação: Brasil
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fístula Vesicovaginal / Laparoscopia / Procedimentos Cirúrgicos Robóticos Tipo de estudo: Prognostic_studies Limite: Adult / Female / Humans / Middle aged Idioma: En Revista: Int Braz J Urol Assunto da revista: UROLOGIA Ano de publicação: 2014 Tipo de documento: Article País de publicação: Brasil