采用膀胱外入路且不进行移植修补的机器人辅助膀胱阴道瘘修补术。
Robotic-assisted vesicovaginal fistula repair using an extravesical approach without interposition grafting.
作者信息
Kelly Erin, Wu Maria Y, MacMillan J Barry
机构信息
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.
出版信息
J Robot Surg. 2018 Mar;12(1):173-176. doi: 10.1007/s11701-017-0694-0. Epub 2017 Mar 28.
BACKGROUND
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.
CASE
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.
CONCLUSION
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.
背景
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。
病例
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。
结论
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。
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