Minimally Invasive Management of Post-treatment Rectovesical Fistulae

Area of Science:

• Urology
• Minimally Invasive Surgery
• Rectovesical Fistula Management

Background:

• Rectovesical fistulae (RVFs) are complex conditions often requiring surgical intervention.
• Minimally invasive techniques offer potential advantages over traditional open surgery for RVF repair.

Purpose of the Study:

• To report the experience and outcomes of minimally invasive management of rectovesical fistulae (RVFs).
• To evaluate the feasibility and safety of robotic and laparoscopic approaches for RVF repair.

Main Methods:

• Retrospective review of 24 patients undergoing minimally invasive RVF repair between 2004 and 2021.
• Data collection included demographics, perioperative, and postoperative variables.
• Complications were classified using the Clavien-Dindo system and EAU guidelines.

Main Results:

• Twenty-four patients (22 males, 2 females) with a median age of 66 years were treated.
• Robotic (79%) and laparoscopic (21%) approaches were utilized, with 96% having prior fecal diversion.
• No intraoperative complications occurred; median operative time was 180 minutes, with low blood loss and short hospital stay (2 days).
• Overall complication rate was low, with two Grade II and one Grade IIIb complication reported.

Conclusions:

• Minimally invasive management of rectovesical fistulae is a feasible and safe approach.
• Robotic and laparoscopic techniques demonstrate potential for successful RVF repair with acceptable complication rates.
• Further studies are warranted to determine the optimal role of minimally invasive surgery in the comprehensive management of RVFs.