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• W2942207568 abstract "You have accessJournal of UrologyFemale Pelvic Medicine & Reconstruction (V12)1 Apr 2019V12-08 ROBOT-ASSISTED VESICO-VAGINAL FISTULA REPAIR: TECHNIQUE & EXPERIENCE Shrawan K Singh*, Girdhar Bora, Kalpesh Parmar, Ravimohan. Mavuduru, Sudheer Devana, Aditya Sharma, and Arup Kumar Mandal Shrawan K Singh*Shrawan K Singh* More articles by this author , Girdhar BoraGirdhar Bora More articles by this author , Kalpesh ParmarKalpesh Parmar More articles by this author , Ravimohan. MavuduruRavimohan. Mavuduru More articles by this author , Sudheer DevanaSudheer Devana More articles by this author , Aditya SharmaAditya Sharma More articles by this author , and Arup Kumar MandalArup Kumar Mandal More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000557522.86109.28AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Standard open trans-abdominal repair of VVF requires a long cystotomy, supra-pubic drainage and delayed recovery while laparoscopic repair in limited by difficult suturing in pelvis with steep learning curve. Utility of robotic assistance is being increasingly explored in difficult pelvic surgeries including repair of vesico-vaginal fistula (VVF). In this current video we share our experience and the technical tips of robot-assisted laparoscopic transvesical VVF repair. METHODS: Data of all patients who underwent robot-assisted VVF repair on DaVinci Si system from December 2014 to September 2018 were collected. All cases underwent pre-operative cysto-vaginoscopy and upper tract imaging. VVF repairs were done in Trendelenburg position with 3-arm pelvic docking. Patient characteristics, operative data, post-operative events and follow up outcomes were analyzed RESULTS: Sixty-four cases of VVF were repaired. Post-hysterectomy VVF was the commonest etiology. 31 patients had complex VVF. Ureteric catheterization was needed in 13 cases due to close proximity to the fistula site. In 2 patients’ simultaneous ureteric re-implantation and in 2 other patients Boari Flap was created (Table 1). Mean durations of drain and hospital stay were 3.4 +/- 1.8 and 9.1 +/- 3.8 days respectively. Follow-up of all patients is available and 2 patients had recurrence. In both the patients the fistula was small and at the previous operative site. Both the fistulae were repaired successfully with robotic assistance. Few useful technical tips for successful outcomes are a. Use of different color catheters across the fistula and ureter. b. Intermittent tugging of the catheter (across the fistula) to identify the site for posterior cystotomy c. Sharp dissection of vaginal and bladder flaps with no or minimal cautrey Interposition of local flaps whenever possible. CONCLUSIONS: Current data suggest that robotic-assisted VVF repair is safe and feasible with good success rate conferring the advantages of minimal invasive surgery Source of Funding: NONE Chandigarh, India© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e1206-e1206 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shrawan K Singh* More articles by this author Girdhar Bora More articles by this author Kalpesh Parmar More articles by this author Ravimohan. Mavuduru More articles by this author Sudheer Devana More articles by this author Aditya Sharma More articles by this author Arup Kumar Mandal More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W2942207568 title "V12-08 ROBOT-ASSISTED VESICO-VAGINAL FISTULA REPAIR: TECHNIQUE & EXPERIENCE" @default.
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