Abstract
For thousands of years, women simply tolerated the distressing symptoms generated by rectovaginal fistulas (RVFs). This is no longer necessary because most RVFs can be surgically corrected via a number of approaches. Most rectovaginal fistulas are acquired; obstetric injury alone accounts for nearly 88% of the cases. The high fistulas are repaired by abdominal approach, while middle or low fistulas are best approached perineally. There are only few case reports of laparoscopic RVF repair noted in literature till date. Laparoscopic repair of RVF is challenging and requires advanced laparoscopic skill. Laparoscopy is a better alternative in selected cases of RVF and yields faster recovery and good patient compliance. We present a case of high RVF managed laparoscopically by using stapler.
Highlights
Obstetric trauma is the most common cause of rectovaginal fistula
Most rectovaginal fistulas are acquired; obstetric injury alone accounts for nearly 88% of the cases
We present a case of high rectovaginal fistulas (RVFs) managed laparoscopically by using stapler
Summary
Obstetric trauma is the most common cause of rectovaginal fistula. Most of the RVFs are managed by conventional open surgery. Abdominal surgeries such as hysterectomies, low anterior resections and ileo-anal anastomosis carry the risk of developing an RVF. RVF can develop secondary to radiation, pelvic malignancy, and diverticular disease. Low RVF can be repaired through perineal approach but high RVF requires transabdominal approach. Laparoscopic approach is feasible in high RVF
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