Department of Minimally Invasive Surgery, Galaxy CARE Laparoscopy Institute, Pune, India.
J Minim Invasive Gynecol. 2013 May-Jun;20(3):334. doi: 10.1016/j.jmig.2013.02.018.
To access the technical feasibility of performing laparoscopic repair of vesicovaginal fistula.
We attempted a laparoscopic repair of vesicovaginal fistula in five women with a history of urinary leakage via the vagina after vaginal hysterectomy. Five pelvic ports were used. The surgical procedure was performed using the same principles as for open surgery, i.e., separation of the vaginal wall from the bladder wall, repair of the fistula, and interposition of the omentum.
There was early recovery of the patients in terms of continence, with less chance of recurrence. Results were comparable to those with the vaginal approach.
The use of minimally invasive surgery for vesicovaginal fistula repair helps to ease the suturing deep in the pelvis, and the magnification facilitates good identification of tissues planes and thus better mobilization of the vaginal and bladder walls and decreases postoperative morbidity.
探讨腹腔镜下修复阴道子宫切除术后阴道漏尿的技术可行性。
对 5 例阴道子宫切除术后阴道漏尿的患者进行腹腔镜下膀胱阴道瘘修补术。使用 5 个盆腔端口。手术过程遵循与开放性手术相同的原则，即分离阴道壁与膀胱壁、修复瘘管和间置大网膜。
患者在控尿方面恢复迅速，复发机会较少。结果与阴道入路相似。
微创技术用于膀胱阴道瘘修补有助于减轻盆腔深部缝合的难度，放大作用有利于更好地识别组织平面，从而更好地移动阴道和膀胱壁，并降低术后发病率。
