Robot-Assisted Uterus-Sparing Repair of a Vesicouterine Fistula 26 Years After Cesarean Section: A Case Report and Review of Surgical Techniques

剖宫产26年后行机器人辅助保留子宫膀胱子宫瘘修补术:病例报告及手术技术回顾

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Abstract

INTRODUCTION AND HYPOTHESIS: This video illustrates the surgical repair of a vesicouterine fistula (VUF) via a transperitoneal, robot-assisted, uterus-sparing approach. METHODS: In this video, we present a VUF that occurred after a cesarean section. The patient presented 22 years later with persistent hematuria. She underwent a uterus-sparing, robot-assisted repair via excision of the fistula tract. The uterus and bladder were closed in multiple layers with omental interposition. RESULTS: The patient tolerated the procedure well. A follow-up cystography confirmed the absence of defects or fistula recurrence. She has remained asymptomatic since the surgery. CONCLUSIONS: Our video demonstrates the feasibility of vesicouterine fistula repair with uterine preservation using an exclusively robot-assisted transperitoneal approach with omental interposition, yielding excellent results.

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