Pietersma Carsten S, Schreuder Henk W R, Kooistra Anko, Koops Steven E Schraffordt
Division of Women and Baby, Department of Reproductive Medicine and Gynaecology, University Medical Centre Utrecht, Utrecht, The Netherlands.
Department of Urology, Meander Medical Centre, Amersfoort, The Netherlands.
BMJ Case Rep. 2014 Jun 10;2014:bcr2014204119. doi: 10.1136/bcr-2014-204119.
Vesicovaginal fistulas are a rare complication of hysterectomy. When conservative therapy fails, vaginal or abdominal repair is necessary. A robotic-assisted laparoscopic approach can be a useful tool to repair complex fistulas. A 50-year-old woman with a vesicovaginal fistula located at the top of the vagina, was treated with robotic-assisted laparoscopic repair. The fistula tissue was removed from the vaginal wall and bladder, and epiploic of the sigmoid was interposed in between. The total operation time was 104 min. The hospital stay was 3 days; no complications occurred. Cystography 6 weeks and 6 months postoperative confirmed a successful repair. A review of current literature is presented regarding the application of robotic assistance during this procedure. The presented case shows that robotic-assisted laparoscopic repair of a vesicovaginal fistula seems to be a feasible technique with promising results.
膀胱阴道瘘是子宫切除术后一种罕见的并发症。当保守治疗失败时，需要进行阴道或腹部修复。机器人辅助腹腔镜手术方法可成为修复复杂瘘管的有用工具。一名50岁患有位于阴道顶部的膀胱阴道瘘的女性接受了机器人辅助腹腔镜修复治疗。瘘管组织从阴道壁和膀胱中切除，将乙状结肠的网膜置于其间。总手术时间为104分钟。住院时间为3天；未发生并发症。术后6周和6个月的膀胱造影证实修复成功。本文对该手术过程中机器人辅助的应用进行了当前文献综述。所呈现的病例表明，机器人辅助腹腔镜修复膀胱阴道瘘似乎是一种可行的技术，效果良好。
