V2159 SUPRAPUBIC TRANSVESICAL LAPAROENDOSCOPIC SINGLE-SITE SURGERY (LESS) FOR VESICOVAGINAL FISTULA REPAIR: INITIAL CLINICAL EXPERIENCE

Abstract

You have accessJournal of UrologySingle Port Surgery1 Apr 2012V2159 SUPRAPUBIC TRANSVESICAL LAPAROENDOSCOPIC SINGLE-SITE SURGERY (LESS) FOR VESICOVAGINAL FISTULA REPAIR: INITIAL CLINICAL EXPERIENCE Marek Roslan, Marcin Markuszewski, Jakub Kedzior, and Kazimierz Krajka Marek RoslanMarek Roslan Gdañsk, Poland More articles by this author , Marcin MarkuszewskiMarcin Markuszewski Gdañsk, Poland More articles by this author , Jakub KedziorJakub Kedzior Gdañsk, Poland More articles by this author , and Kazimierz KrajkaKazimierz Krajka Gdañsk, Poland More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2331AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Some minimally invasive techniques have been introduced to decrease morbidity related to standard laparoscopic procedures. One such approach is laparoendoscopic single-site surgery (LESS). We describe our initial clinical experience of using this technique for transvesical vesicovaginal fistula (VVF) repair. METHODS In August 2011, we carried out the LESS repair of a 5-mm in diameter vesicovaginal fistula on a 72-year old woman, who failed the conservative treatment with Foley placement. The procedure was performed transvesically (percutaneous intraluminal approach) with a single-port device (4-channel) via a 1.5-cm incision made 2 cm above the pubic symphysis. A standard 10-mm optic and straight laparoscopic instruments were used. The fistulous tract was dissected and partially excised. The bladder and vaginal walls' defects were closed in two layers with running absorbable V-Loc™ suture. Ureteral catheters were left for 5 days and Foley catheter for 14 days RESULTS The operation lasted 170 minutes. The blood loss was minimal. No complications were observed. The postoperative period was uneventful. During a two-month follow-up the patient reported no involuntary discharge of urine into the vagina. Diagnostic scans revealed no presence of VVF and laboratory examination results were all within normal range. CONCLUSIONS Although substantial development of the instruments and skills is needed, the transvesical LESS vesicvaginal fistula repair appeared to be feasible and safe. Nevertheless, further experience and observations are necessary. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e871 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Marek Roslan Gdañsk, Poland More articles by this author Marcin Markuszewski Gdañsk, Poland More articles by this author Jakub Kedzior Gdañsk, Poland More articles by this author Kazimierz Krajka Gdañsk, Poland More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...