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Sotelo R, Medina LG, Husain FZ, Khazaeli M, Nikkhou K, Cacciamani GE, Landsberger H, Winter M, Hernandez A, Kaiser AM, Gill I. Robotic-assisted laparoscopic repair of rectovesical fistula after Hartmann's reversal procedure. J Robot Surg 2018; 13:339-343. [PMID: 30062640 DOI: 10.1007/s11701-018-0854-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 07/23/2018] [Indexed: 01/16/2023]
Abstract
The case is of a 59-year-old male with history of severe ischemic colitis following emergent intervention for a ruptured infrarenal aortic aneurysm who subsequently underwent left hemicolectomy, partial proctectomy, and Hartmann colostomy. The patient later underwent reversal of the Hartmann colostomy with diverting ileostomy. The surgery was complicated by a right ureteral and posterior bladder injury that resulted in a large rectovesical fistula involving the right hemitrigone and right ureteral orifice. An attempt to repair the rectovesical fistula at an outside facility was unsuccessful. Then, he underwent a robotic-assisted laparoscopic repair of rectovesical fistula, including simple prostatectomy, excision of rectovesical fistulous tract, rectal closure, peritoneal and omental flap interposition, bladder neck reconstruction, vesicourethral anastomosis and right ureteral reimplantation. There were no intraoperative or postoperative complications, and the patient was discharged at postoperative day 4; cystoscopy at 6-week follow-up demonstrated a successful closure of the fistula, at which time the ureteral stents were removed.
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Affiliation(s)
- R Sotelo
- Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - L G Medina
- Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - F Z Husain
- Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - M Khazaeli
- Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - K Nikkhou
- Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - G E Cacciamani
- Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - H Landsberger
- Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - M Winter
- Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - A Hernandez
- Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - A M Kaiser
- Department of Colorectal Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - I Gill
- Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Oderda M, Bonet X, Campobasso D, Gaston R. Robotic rectovesical fistula repair: a successful approach. J Laparoendosc Adv Surg Tech A 2015; 24:567-70. [PMID: 25062340 DOI: 10.1089/lap.2014.0002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To describe our technique of robotic rectovesical fistula (RVF) repair through the report of a case unique for its pathogenesis. RVF is a rare but devastating complication of prostatic surgery and can nowadays be managed with a minimally invasive approach. PATIENT AND METHODS We describe in detail all the steps of our robotic RVF repair, performed on a 76-year-old man who developed RVF after radical prostatectomy. The RVF had been induced by tissue erosion due to Hem-o-lok(®) (Teleflex Medical, Research Triangle Park, NC) clips and had been unsuccessfully treated with an over-the-scope clip. RESULTS Our surgery was successful with an operative time of 70 minutes and an estimated blood loss of 150 mL. The postoperative course was uneventful, and the patient was discharged on postoperative Day 3. CONCLUSIONS Our technique of robotic RVF repair was safe and effective. Care must be taken when considering new, endoscopic devices for the cure of RVF. A prospective study with a long follow-up is advised to validate our results.
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Affiliation(s)
- Marco Oderda
- 1 Department of Urology, Clinique Saint Augustin , Bordeaux, France
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