Robot Assisted Laparoscopic Repair of Vesicovaginal Fistula: A Retrospective Study at a Tertiary Care Centre, Chennai, India
Introduction: Vesicovaginal Fistula (VVF) is the most common acquired fistula of the urinary tract in women. Robotic surgery is recently introduced for VVF repair and has benefits over conventional methods. Aim: To describe experience with robot-assisted laparoscopic repair of VVF in patients. Mat...
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| Format: | Article |
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JCDR Research and Publications Private Limited
2022-01-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://www.jcdr.net/articles/PDF/15861/49950_CE(Ra1)_F(SS)_PF1(SC_SS)_PFA(SC_KM)_PN(KM).pdf |
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| author | Mohsin Quadri G Thirumalai B Arun Kumar K Ramesh Deepak Raghavan KS Ananth Nitesh Jain |
| author_facet | Mohsin Quadri G Thirumalai B Arun Kumar K Ramesh Deepak Raghavan KS Ananth Nitesh Jain |
| author_sort | Mohsin Quadri |
| collection | DOAJ |
| description | Introduction: Vesicovaginal Fistula (VVF) is the most common acquired fistula of the urinary tract in women. Robotic surgery is recently introduced for VVF repair and has benefits over conventional methods.
Aim: To describe experience with robot-assisted laparoscopic repair of VVF in patients.
Materials and Methods: This was a retrospective observational study conducted from February 2014 to February 2018, at Department of Urology, Apollo Main Hospital, Chennai, Tamil Nadu, India. The study included 24 patients who underwent robot-assisted laparoscopic VVF repair. After cystoscopy ureteric catheter was passed through the fistula and retrieved through vagina. Bilateral ureteric catheters were placed simultaneously with vaginal packing. Da Vinci Si robot was docked with patient in trendelenburg position. After trocar placement transperitoneally the fistula was approached. Through vertical or transverse cystotomy, fistula was identified. With the circumferential incision around the fistula, both the bladder and vagina was separated and the fistulous tract was excised. Bladder was closed vertically and vaginal opening was closed transversely interposing the Omentum. Statistical analyses were performed using the Statistical Package for Social Sciences (SPSS) version 20.0.
Results: The mean age of participants was 40.33 years. Elective hysterectomy done for benign conditions (91.67%) was the major cause of VVF in patients followed by emergency hysterectomy (8.33%). All of the patients underwent adhesiolysis while two patients performed right ureteric re-implantation additionally. The median operative time was 127.50 minutes. The median duration of drain and hospital stay was three days each. Urethral Foley’s catheter removal done at 2-3 weeks based on operating surgeon’s preference and the mean duration of follow-up was 26 months.
Conclusion: Robot-assisted laparoscopic VVF repair is convenient and an effective approach in the successful management of VVF in complex fistulas and recurrent cases. |
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| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-04-10T19:34:08Z |
| publishDate | 2022-01-01 |
| publisher | JCDR Research and Publications Private Limited |
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| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-1ccef1492eca456baf6396c88edd74b32023-01-30T09:30:55ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2022-01-01161PC01PC0410.7860/JCDR/2022/49950.15861Robot Assisted Laparoscopic Repair of Vesicovaginal Fistula: A Retrospective Study at a Tertiary Care Centre, Chennai, IndiaMohsin Quadri0G Thirumalai1B Arun Kumar2K Ramesh3Deepak Raghavan4KS Ananth5Nitesh Jain6Ex-Registrar, Department of Urology, Apollo Main Hospital, Chennai, Tamil Nadu, India.Consultant, Department of Urology, Apollo Main Hospital, Chennai, Tamil Nadu, India.Consultant, Department of Urology, Apollo Main Hospital, Chennai, Tamil Nadu, India.Consultant, Department of Urology, Apollo Main Hospital, Chennai, Tamil Nadu, India.Consultant, Department of Urology, Apollo Main Hospital, Chennai, Tamil Nadu, India.Consultant, Department of Urology, Apollo Main Hospital, Chennai, Tamil Nadu, India.Consultant, Department of Urology, Apollo Main Hospital, Chennai, Tamil Nadu, India.Introduction: Vesicovaginal Fistula (VVF) is the most common acquired fistula of the urinary tract in women. Robotic surgery is recently introduced for VVF repair and has benefits over conventional methods. Aim: To describe experience with robot-assisted laparoscopic repair of VVF in patients. Materials and Methods: This was a retrospective observational study conducted from February 2014 to February 2018, at Department of Urology, Apollo Main Hospital, Chennai, Tamil Nadu, India. The study included 24 patients who underwent robot-assisted laparoscopic VVF repair. After cystoscopy ureteric catheter was passed through the fistula and retrieved through vagina. Bilateral ureteric catheters were placed simultaneously with vaginal packing. Da Vinci Si robot was docked with patient in trendelenburg position. After trocar placement transperitoneally the fistula was approached. Through vertical or transverse cystotomy, fistula was identified. With the circumferential incision around the fistula, both the bladder and vagina was separated and the fistulous tract was excised. Bladder was closed vertically and vaginal opening was closed transversely interposing the Omentum. Statistical analyses were performed using the Statistical Package for Social Sciences (SPSS) version 20.0. Results: The mean age of participants was 40.33 years. Elective hysterectomy done for benign conditions (91.67%) was the major cause of VVF in patients followed by emergency hysterectomy (8.33%). All of the patients underwent adhesiolysis while two patients performed right ureteric re-implantation additionally. The median operative time was 127.50 minutes. The median duration of drain and hospital stay was three days each. Urethral Foley’s catheter removal done at 2-3 weeks based on operating surgeon’s preference and the mean duration of follow-up was 26 months. Conclusion: Robot-assisted laparoscopic VVF repair is convenient and an effective approach in the successful management of VVF in complex fistulas and recurrent cases.https://www.jcdr.net/articles/PDF/15861/49950_CE(Ra1)_F(SS)_PF1(SC_SS)_PFA(SC_KM)_PN(KM).pdfadhesiolysiscathetercystoscopyda vinci si robotoophorectomy |
| spellingShingle | Mohsin Quadri G Thirumalai B Arun Kumar K Ramesh Deepak Raghavan KS Ananth Nitesh Jain Robot Assisted Laparoscopic Repair of Vesicovaginal Fistula: A Retrospective Study at a Tertiary Care Centre, Chennai, India Journal of Clinical and Diagnostic Research adhesiolysis catheter cystoscopy da vinci si robot oophorectomy |
| title | Robot Assisted Laparoscopic Repair of Vesicovaginal Fistula: A Retrospective Study at a Tertiary Care Centre, Chennai, India |
| title_full | Robot Assisted Laparoscopic Repair of Vesicovaginal Fistula: A Retrospective Study at a Tertiary Care Centre, Chennai, India |
| title_fullStr | Robot Assisted Laparoscopic Repair of Vesicovaginal Fistula: A Retrospective Study at a Tertiary Care Centre, Chennai, India |
| title_full_unstemmed | Robot Assisted Laparoscopic Repair of Vesicovaginal Fistula: A Retrospective Study at a Tertiary Care Centre, Chennai, India |
| title_short | Robot Assisted Laparoscopic Repair of Vesicovaginal Fistula: A Retrospective Study at a Tertiary Care Centre, Chennai, India |
| title_sort | robot assisted laparoscopic repair of vesicovaginal fistula a retrospective study at a tertiary care centre chennai india |
| topic | adhesiolysis catheter cystoscopy da vinci si robot oophorectomy |
| url | https://www.jcdr.net/articles/PDF/15861/49950_CE(Ra1)_F(SS)_PF1(SC_SS)_PFA(SC_KM)_PN(KM).pdf |
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