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Urinary Tract Calculi VI: Surgical Management01:25

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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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Vesicovaginal Fistula Robotics-Assisted Repair: A Systematic Review and Quantitative Synthesis.

Miguel Tavares1, Maria do Carmo Pinto2,3, Gonçalo Conde Carvalho4

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Robotics-assisted repair for vesicovaginal fistula (VVF) is safe and effective, showing low complication and recurrence rates. This robotic surgery approach is particularly beneficial for complex and recurrent VVF cases.

Keywords:
ExtravesicalRobotics-assisted surgeryTransabdominal repairTransvaginal repairTransvesicalVesicovaginal fistula

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Gynecologic Surgery

Background:

  • Vesicovaginal fistula (VVF) is a challenging condition requiring effective surgical repair.
  • Robotic surgery offers potential advantages in complex pelvic procedures.

Purpose of the Study:

  • To systematically review and compare outcomes of transvesical versus extravesical robotics-assisted VVF repair.
  • To evaluate the safety and efficacy of robotic VVF repair, especially in recurrent cases.

Main Methods:

  • Systematic review of PubMed, Scopus, and Web of Science databases.
  • Inclusion of comparative studies and case series (n≥5) on robotic VVF repair.
  • Analysis of operative time, blood loss, complications, recurrence, hospitalization, and catheterization time.

Main Results:

  • Fourteen studies (206 patients) analyzed; low overall complication (4.37%) and recurrence (2.91%) rates.
  • Minimal estimated blood loss and short hospital stays reported across studies.
  • No significant difference in outcomes between transvesical and extravesical robotic approaches; high success in recurrent VVF cases.

Conclusions:

  • Robotics-assisted VVF repair is a safe, effective, and reproducible technique.
  • The approach demonstrates minimal blood loss, low complication rates, and short hospital stays.
  • Robotic surgery is a valuable option for VVF repair, particularly in recurrent or complex cases.