Robot-assisted vesicovaginal fistula repair - initial experience

Purpose: To report our initial experience of robot-assisted vesicovaginal fistula (VVF) repair.Materials and methods: Data from all patients who underwent robot-assisted VVF repair from August 2015 to October 2018 were analyzed. Preoperative data included age, BMI, smoking status, alcohol consumption, etiology of fistula and location and size of fistula. Operative data was operation time and the use of tissue interposition. Postoperative data included time to follow up, complications and reoperations.Results: A total of 13 patients underwent robot-assisted VVF repair and 15 operations were performed as 2 patients required a repeated procedure. The mean age was 45.0 ± 14.5 years (±SD) and operative time was 138.3 ± 58.9 min (±SD). The mean time to follow up was 18.3 ± 16.1 weeks (±SD). Postoperative complications were reported by one patient and was Clavien-Dindo I. Relapse of fistula was found in two patients who had a successful reoperation with repeated robotic-assisted surgery. An interposition flap was used in a single patient. The overall success rate was 84.6% after primary surgery (11 out of 13) and 100% after repeated procedure (2 out of 2).Conclusions: In this initial small series, we found that robot-assisted VVF repair is a safe procedure with results comparable to transvaginal repair. This procedure has a high success rate and few complications without using interposed tissue.