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Updated: Jul 7, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
TEMS: an alternative method for the repair of benign recto-vaginal fistulae
1Department of Gastro-intestinal Surgery, Cheltenham General Hospital, Cheltenham, UK. rosie_darwood@btinternet.com
Indications:
The repair of high recto-vaginal fistula can be challenging since access may be limited via the endo-anal approach yet the alternative trans-abdominal route carries significant morbidity. We report the use of TEMS to repair a recto-vaginal fistula following anterior resection and pelvic radiotherapy.
Method:
The patient was placed prone and a 25 cm rectoscope was inserted. A proximally based mucosal advancement flap was raised to repair the fistula. The patient was discharged 2 days later and a contrast study confirmed closure of the fistula. COMPARISON WITH OTHER TECHNIQUES: TEMS allows excellent visualisation of a rectovaginal fistula compared to standard endo-anal or trans-vaginal techniques. The morbidity is lower than the trans-abdominal route.
Comments:
TEMS is a useful technique for the repair of benign recto-vaginal fistula and has distinct advantages over conventional techniques.
