Robotic-assisted vesicovaginal fistula repair

Abstract

Vesicovaginal fistula is a challenging condition to manage. Traditionally, repair techniques have been limited to transvaginal and abdominal approaches. More recently, laparoscopic approaches have been utilized in order to combine the advantages of abdominal approach while minimizing post-operative recovery. Robotic technology offers a minimally invasive approach to fistula repair with advantages that make adherence to the traditional principles of fistula repair less technically challenging. Robotic technology allows for increased operative range of motion and more facile pelvic dissection to better develop tissue planes. Improved visualization has helped decrease the morbidity of this procedure by making use of less invasive extravesical repairs. Lastly, intracoporeal suturing is more easily accomplished with the use of robotic technology, facilitating tissue closures. Robotic-assisted vesicovaginal fistula repair appears to be a safe procedure and provides advantages over laparoscopic repair. Most importantly, it appears to have outcomes as successful as other operative approaches.