Robotic rectovesical fistula repair: a successful approach

Abstract

Objective: To describe our technique of robotic rectovesical fistula (RVF) repair through the report of a case unique for its pathogenesis. RVF is a rare but devastating complication of prostatic surgery and can nowadays be managed with a minimally invasive approach.

Patient and methods: We describe in detail all the steps of our robotic RVF repair, performed on a 76-year-old man who developed RVF after radical prostatectomy. The RVF had been induced by tissue erosion due to Hem-o-lok(®) (Teleflex Medical, Research Triangle Park, NC) clips and had been unsuccessfully treated with an over-the-scope clip.

Results: Our surgery was successful with an operative time of 70 minutes and an estimated blood loss of 150 mL. The postoperative course was uneventful, and the patient was discharged on postoperative Day 3.

Conclusions: Our technique of robotic RVF repair was safe and effective. Care must be taken when considering new, endoscopic devices for the cure of RVF. A prospective study with a long follow-up is advised to validate our results.