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- W2981216518 abstract "Video Objective This video demonstrates the repair of a high rectovaginal fistula done laparoscopically. Setting A 53 year old lady complained of involuntary passage of flatus and faeces per vaginum post hysterectomy done for abnormal uterine bleeding. Dye study and distal loopogram revealed presence of contrast leak. However, on clinical examination, there was no communication felt between rectum and vagina as the fistula was high up at the apex of the vault. Interventions High rectovaginal fistulae, usually seen following benign gynaecological procedures like vaginal hysterectomies are best approached laparoscopically as demonstrated. Rectal fistula and vaginal fistula were sutured independently following adhesiolysis and mobilisation of vaginal vault. The three principles of fistula repair: excision of fistulous tract, reconstruction in layers after refreshing the edges and reposition with omental flap, were followed for either of the fistulae. Delayed absorbable sutures were used for suturing and omentum was mobilised to create a flap over the affected area. The omental flap was also sutured to the surrounding area of the fistula to keep it in position or “reposition” with the same. No covering colostomy was required and the patient was discharged with regular bowel and bladder functions. Laparoscopic approach reduces the blood loss, post-operative stay in the hospital and the morbidity. On follow up with dye study and distal loopogram, absence of contrast leak was seen without any presenting complaints. Conclusion Thus, repair of rectovaginal fistula can be achieved successfully through minimally invasive surgery." @default.
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- W2981216518 date "2019-11-01" @default.
- W2981216518 modified "2023-09-26" @default.
- W2981216518 title "1749 Laparoscopic Rectovaginal Fistula Repair Following Benign Gynaecological Procedure" @default.
- W2981216518 doi "https://doi.org/10.1016/j.jmig.2019.09.151" @default.
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