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Robotic assisted laparoscopic repair of vesico-vaginal fistula: the extravesical approach
Department of Urology, Mayo Clinic Florida, Jacksonville, Florida, USA
Oct  2012 (Vol.  19, Issue  5, Pages( 6474 - 6476)
PMID: 23040631


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  • The optimal method of vesico-vaginal fistula (VVF) repair remains undetermined. Almost all previous descriptions of laparoscopic/robotic fistula repair involve utilizing a vertical cystotomy to identify the fisula. Avoidance of an intravesical approach to vesico-vaginal fistula repair may decrease patient morbidity. Patient selection, patient positioning, fistula recognition, port placement, intra-operative dissection techniques, flap formation, and repair are outlined in this video of robotic repair of vesico-vaginal fistula utilizing an extravesical approach. The extravesical robotic repair has been successfully utilized in two patients with VVF following hysterectomy. This manuscript and video demonstrates that vesico-vaginal fistulae can be repaired with a robotic assisted extravesical approach avoiding the morbidity of a large cystotomy.