Laparoscopic stapler repair of high rectovaginal fistula: A case report

Amit Kumar Parmar, Mittu John Mathew, Prasanna Kumar Reddy

Department of Surgical Gastroenterology and Minimal Access Surgery, Apollo Hospital, Chennai, India.

DOI: 10.4236/ojgas.2013.31005                

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.

Keywords

Laparoscopy; Rectovaginal Fistula; Stapler

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Pelosi III, M.A. and Pelosi, M.A. (1997) Transvaginal repair of recurrent rectovaginal fistula with laparoscopic assisted rectovaginal mobilization. Journal of Laparoendoscopic & Advanced Surgical Techniques, 7, 379-383. doi:10.1089/lap.1997.7.379
[2]	Palanivelu, C., Rangarajan, M., Senthilkumar, R., Ma dankumar, M.V. and Kalyanakumari, V. (2007) Laparo scopic management of iatrogenic high rectovaginal fistulas (type VI). Singapore Medical Journal, 48, e96-e98.
[3]	Arnold, M.W., Aguilar, P.S. and Stewart, W.R.C. (1990) Vaginography: An easy and safe technique for diagnosis of colovaginal fistulas. Diseases of the Colon & Rectum, 33, 344-345. doi:10.1007/BF02055482
[4]	Bird, D., Taylor, D. and Lee, P. (1993) Vaginography: The investigation of choice for vaginal fistulae? Australian and New Zealand Journal of Surgery, 63, 894-896. doi:10.1111/j.1445-2197.1993.tb00366.x
[5]	Giordano, P., Drew, P.J. and Taylor, D. (1996) Vaginography—Investigation of choice for clinically suspected vaginal fistulas. Diseases of the Colon & Rectum, 39, 568-572. doi:10.1007/BF02058713
[6]	Nezhat, C.H., Bastidas, J.A., Pennington, E., Nezhat, F.R., Raga, F. and Nezhat, C.R. (1998) Laparoscopic treatment of type IV rectovaginal fistula. Journal of the American Association of Gynecologic Laparoscopists, 5, 297-299. doi:10.1016/S1074-3804(98)80036-4
[7]	Schwenk, W., Bohm, B., Grundel, K. and Muller, J. (1997) Laparoscopic resection of high rectovaginal fistula with intracorporeal colorectal anastomosis and omentoplasty. Surgical Endoscopy, 11, 147-149. doi:10.1007/s004649900318