Hellow guys, Welcome to my website, and you are watching Robotic-assisted VVF Repair with Excision of Mesh and Simultaneous Intravesical Ureteral Re-implant.. and this vIdeo is uploaded by Wilson Alobuia at 2013-07-11T14:32:41-07:00. We are pramote this video only for entertainment and educational perpose only. So, I hop you like our website.
| Name | Robotic-assisted VVF Repair with Excision of Mesh and Simultaneous Intravesical Ureteral Re-implant. |
| Video Uploader | Video From Wilson Alobuia |
| Upload Date | This Video Uploaded At 11-07-2013 21:32:41 |
| Video Discription | TITLE: Robotic-assisted Vesicovaginal fistula (VVF) Repair with Excision of Mesh and Simultaneous Intravesical Ureteral Re-implant. **Accepted for presentation at the World Congress of Endourology (WCE) 2013 Annual Meeting - New Orleans, LO Authors: Jeffrey B. Marotte, Wilson M. Alobuia INTRODUCTION AND OBJECTIVES Urologic complications from hysterectomy such as vesicovaginal fistula (VVF) and ureteral injury are known to occur at a rate of approximately 1%. When a hysterectomy is indicated for uterine prolapse, simultaneous sacrocolpopexy can also result in a different complication such as mesh erosion. Using robotic assisted approach has been shown to be a favorable option when the abdominal approach is warranted in the event ureteral reimplant is needed for ureteral orifices positioned near the fistula tract or a co-existent ureterovaginal fistula. For distal, intramural ureteral strictures, intravesical ureteral excision and mobilization can be performed, obviating the need to perform an extravesical ureteral reimplant. METHODS We present a case of a 48 year old woman who had a robotic total hysterectomy with sacrocolpopexy performed. She developed a VVF and underwent two failed repairs; one abdominal and one vaginal, with the later causing a distal ureteral stricture not successfully managed with stenting. A robotic VVF repair was performed with an intravesical ureteral reimplant. RESULTS The patient had a successful repair of her VVF and excision of a distal ureteral stricture with no hydronephrosis nor incontinence. CONCLUSIONS To our knowledge this is the first report of robotic assisted VVF repair with excision of mesh and intravesical ureteral reimplant. The two failures from her prior surgeries likely failed secondary to incomplete removal of mesh involved with the fistula tract. The video emphasizes the importance of adherence to strict surgical principles of repair of VVF as historically documented in the literature, but also the importance for complete mesh excision. We introduce a novel surgical option of intravesical ureteral reimplant/mobilization, should the intramural ureter have injury or if it is too close to the fistula tract. |
| Category | People & Blogs |
| Tags | urinary bladder | female urology | vesicovaginal | fistula | ureteral | reimplant | mesh | Vesicovaginal Fistula (Disease Or Medical Condition) | Therapy | Medicine (Field Of Study) | mesh erosion | sacrocolpopexy |
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