What Researchers Did
Researchers described a robotic-assisted surgical technique using a vaginal cuff flap to repair complex vesicovaginal and rectovaginal fistulas in a 56-year-old woman who had previously undergone ovarian debulking surgery and radiotherapy.
What They Found
The robotic surgery took 9 hours with an estimated blood loss of 300 cc, and the patient was discharged on postoperative day 8 without intraoperative complications. Following the initial surgery, the patient received 37 sessions in a hyperbaric chamber and underwent another bladder closure procedure 10 months later. At 30 months of follow-up, there was no recurrence of the fistula.
Canadian Relevance
This study is not Canadian. However, the patient's vesicovaginal fistula developed after radiotherapy, which falls under the Health Canada-recognised indication of delayed radiation injury, for which hyperbaric oxygen therapy is an approved treatment.
Study Limitations
As a case report, this study describes the experience of a single patient, limiting the generalizability of its findings to a broader population.