Tavares M A, Campagne Lpiseau S, Canis M, Botchorishvili R
Facts Views Vis Obgyn. 2021 Jun;13(2):175-178. doi: 10.52054/FVVO.13.2.022.
Vesicovaginal fistulas (VVF) are an unusual problem that may significantly affect a patient's quality of life. The main causes for this condition are labour complications (mostly in developing countries) and pelvic surgeries (in industrialised countries). Treatment may be conservative or surgical. Regarding surgical treatment, there is still debate about the best approach and surgical technique.
To demonstrate a correction of a VVF guided by cystoscopy using intravesical laparoscopic instruments.
Case report and surgical video of a recurrent VVF treated with a hybrid technique involving direct transvesical insertion of 3 mm laparoscopic trocars and instruments guided by cystoscopy. As far as we know, although there are some reported techniques that use a combination of transvesical laparoscopic instruments and cystoscopy, this is the least invasive and most ergonomic technique described.
Two years after surgery, the patient remains asymptomatic and with no fistula recurrence.
The transvesical approach guided by cystoscopy seems to be an effective, safe and ergonomic minimally invasive procedure for VVF repair.
膀胱阴道瘘（VVF）是一个不常见的问题，可能会严重影响患者的生活质量。导致这种情况的主要原因是分娩并发症（主要在发展中国家）和盆腔手术（在工业化国家）。治疗方法可以是保守治疗或手术治疗。关于手术治疗，对于最佳方法和手术技术仍存在争议。
展示一种在膀胱镜引导下使用膀胱内腹腔镜器械矫正膀胱阴道瘘的方法。
病例报告及手术视频，该复发性膀胱阴道瘘采用了一种混合技术治疗，即通过膀胱镜引导直接经膀胱插入3毫米腹腔镜套管针和器械。据我们所知，虽然有一些报道的技术使用经膀胱腹腔镜器械和膀胱镜的组合，但这是所描述的侵入性最小且最符合人体工程学的技术。
术后两年，患者无症状，瘘管无复发。
膀胱镜引导下的经膀胱入路似乎是一种有效、安全且符合人体工程学的微创膀胱阴道瘘修复手术。
