Kelly Erin, Wu Maria Y, MacMillan J Barry
Division of Urogynecology, Department of Obstetrics and Gynecology, London Health Sciences Centre, Victoria Campus, Western University, Room B2 401, 800 Commissioners Road East, London, ON, N6H 5W9, Canada.
J Robot Surg. 2018 Mar;12(1):173-176. doi: 10.1007/s11701-017-0694-0. Epub 2017 Mar 28.
Post-hysterectomy vesicovaginal fistula (VVF) is rare. In addition to conventional abdominal and vaginal approaches, robotic-assisted VVF repairs have recently been described. We present a case of an extravesical, robotic-assisted VVF repair, without placement of an interposition graft performed in a Canadian teaching center.
A 51-year-old woman presented with urinary incontinence 5 days after laparoscopic hysterectomy. Computed tomography cystogram, cystoscopy, and methylene blue dye test, confirmed a VVF above the bladder trigone. The patient underwent a robotic-assisted VVF repair 3 months after presentation, without complication. An abdominal, extravesical approach was used. Operative time was 116 min and repeat CT cystogram showed no evidence of persistent.
We have demonstrated that a VVF repair, using a robotic-assisted, extravesical approach without interposition graft placement, can be safe, less invasive and have a successful outcome at 1 year of follow-up.
子宫切除术后膀胱阴道瘘（VVF）较为罕见。除了传统的腹部和阴道手术方法外，近年来还出现了机器人辅助的VVF修复术。我们报告了一例在加拿大教学中心进行的膀胱外机器人辅助VVF修复病例，未置入补片。
一名51岁女性在腹腔镜子宫切除术后5天出现尿失禁。计算机断层扫描膀胱造影、膀胱镜检查和亚甲蓝染料试验证实膀胱三角上方存在VVF。患者在就诊3个月后接受了机器人辅助VVF修复术，无并发症发生。采用腹部膀胱外入路。手术时间为116分钟，复查CT膀胱造影显示无持续性瘘管迹象。
我们证明了采用机器人辅助膀胱外入路且不置入补片的VVF修复术是安全的，创伤较小，且在1年随访时效果良好。
