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Robotic-assisted laparoscopic repair of a vesicouterine fistula
Shao-Chun R Chang-Jackson1, Uchenna C Acholonu, Farr R Nezhat
1Department of Obstetrics and Gynecology, St. Luke's-Roosevelt Hospital Center, Academic Affiliate of Columbia University, College of Physicians and Surgeons, New York, New York, USA.
Background:
As cesarean sections become a more common mode of delivery, they have become the most likely cause of vesicouterine fistula formation. The associated pathology with repeat cesarean deliveries may make repair of these fistulas difficult. Computer-enhanced telesurgery, also known as robotic-assisted surgery, offers a 3-dimensional view of the operative field and allows for intricate movements necessary for complex suturing and dissection. These qualities are advantageous in vesicouterine fistula repair.
Case:
A healthy 34-year-old woman who underwent 4 cesarean deliveries presented with a persistent vesicouterine fistula. Conservative management with bladder decompression and amenorrhea-inducing agents failed.
Results:
Robotic-assisted laparoscopic repair was successfully performed with the patient maintaining continence after surgery.
Conclusion:
Robotic-assisted laparoscopic repair of vesicouterine fistulas offers a minimally invasive approach to treatment of a complex disease process.