Robotic repair of a vesicovaginal fistula in an irradiated field using a dehydrated amniotic allograft as an interposition patchReport as inadecuate




Robotic repair of a vesicovaginal fistula in an irradiated field using a dehydrated amniotic allograft as an interposition patch - Download this document for free, or read online. Document in PDF available to download.

Journal of Robotic Surgery

, Volume 10, Issue 1, pp 77–80

First Online: 11 December 2015Received: 11 November 2015Accepted: 22 November 2015

Abstract

We report the case of a 66 year old female with a supratrigonal vesicovaginal fistula VVF that developed after undergoing radical hysterectomy, chemotherapy and pelvic radiation therapy for advanced cervical cancer.
VVF repairs in an irradiated field are known to be complicated procedures with significant morbidity and a high rate of failure due to the effect of radiation.
Amniotic membranes have been demonstrated to improve healing rates in difficult to heal wounds.
To decrease morbidity a minimally invasive robotic procedure was performed and a dehydrated amniotic allograft patch was used to augment tissue healing.
The VVF was repaired using the da Vinci Surgical System and the amniotic membrane was used as an interposition patch over the repair.
There were no operative or postoperative complications and the patient was discharged home on postoperative day one.
A cystogram performed 3 weeks postoperatively demonstrated a healed fistula.
Follow-up at 5 months revealed no incontinence.
This is the first reported case of a robotic VVF repair performed in an irradiated pelvis and the first use of an amniotic membrane allograft in the repair a VVF.

KeywordsVesicovaginal fistula Pelvic irradiation Robotic surgery Amniotic graft Wound healing Electronic supplementary materialThe online version of this article doi:10.1007-s11701-015-0546-8 contains supplementary material, which is available to authorized users.

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Author: David T. Price - Tina C. Price

Source: https://link.springer.com/article/10.1007/s11701-015-0546-8



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