48 You can do it: Laparoscopic repair of a recurrent vesicovaginal fistula

Abstract

This video demonstrates how the skill set required to perform laparoscopic sacral colpopexy can be used to repair a vesicovaginal fistula. The video describes the case of a 43-year-old woman who presented with a recurrent post-hysterectomy fistula after a Latzko-style repair. It then demonstrates how the bladder dissection required for fistula repair resembles the dissection required for sacral colpopexy, and how repairing the bladder wall after excision of the fistula tract is similar to repairing an accidental cystotomy of the type that occurs during sacral colopexy. Vesicovaginal fistulas are rare in the developed world, which means that few surgeons have extensive experience in repairing them. Despite this, surgeons who have the skills to perform laparoscopic and robotic sacral colopexy should feel confident that they have the requisite skills to approach fistulas in a minimally invasive way when required.