Keitaro Nakamoto, Paul Bown. Marshall University Joan C. Edwards School of Medicine
Introduction: The objective of this study was to review our institution’s experience on robotic-assisted laparoscopic sigmoid resection with repair of vaginal defect and diverting loop ileostomy as a primary treatment modality for colovaginal fistula.
Methods and Procedures: Patients with colovaginal fistulas treated by two surgeons (one general surgeon and one OB/GYN) between January 2018 and September 2018 were identified. A retrospective chart review was performed to determine outcomes including length of stay, operative times and complications.
Results: There were 4 patients identified. Median age was 72.5. All patient had a history of hysterectomy. All patients underwent cystoscopy with ureteral stent placement, robotic-assisted laparoscopic sigmoid resection with primary anastomosis, repair of vaginal defect, and diverting loop ileostomy. Average operative time was 223 minutes. Median length of stay for initial procedure was 2.5 days. All patients underwent ileostomy reversal. Median time to ileostomy reversal was 35.5 days. Median length of stay after ileostomy reversal was 2.9 days. Median total length of stay overall was 5.4 days. There was one readmission due to high ileostomy output, otherwise there were no complications.
Conclusions: Robotic-assisted laparoscopic sigmoid resection, with vaginal defect repair and diverting ileostomy is a safe and effective way of managing colovaginal fistulas. This is an ongoing case series with more data expected to be added.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95264
Program Number: P662
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster