V10-03: Fistulectomy and full thickness advencement flap for recto-neobladder fistula
VideoIntroductions and Objectives
Rectal injury is a severe complication after prostate or bladder cáncer._x000D_ Several of the rectal injuries will became in delayes fistulas._x000D_ Although multiples techniques have been described, there is no consensus about how to resolve it._x000D_ _x000D_ Objetive_x000D_ _x000D_ We present the transanal aproach with excision of the fistula and an advancement flap to resolve it.
A 55 years old man with a cistectomy with Studer neobladder presents rectum-neobladder fistula after surgery 4 years ago. He presented good tolerance until he presented a worsenig of his renal function._x000D_ Cistography and cistoscopy showed a small 5 mm fistula, 4 cm from the anal margin.
We describe the patient position, Da Vinci robot and trocars position and tips-and-tricks in dissection and suture technique. All the surgery is performed through a robot transanal device.
Transanal minimally invasive surgery (TAMIS) is a valid_x000D_ alternative to treat vesicorectal fistulas. This technique is effective_x000D_ and reproductible and the robotic approach facilitates its performance.