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Rectovaginal fistula repair using a disposable biopsy punch.

ABSTRACT: To describe a novel surgical technique for complete excision of a rectovaginal fistula tract using a disposable biopsy punch during a transvaginal rectovaginal fistula repair and to present our initial surgical experience.Description of 4 cases of simple rectovaginal fistulas and an innovative surgical technique for the complete excision of the fistula tract using a disposable biopsy punch.Successful 3-, 9-, and 12-month follow-up of 4 cases with simple rectovaginal fistulas after transvaginal rectovaginal fistula repair using a novel approach for complete fistula tract excision with a disposable biopsy punch and layered nonoverlapping suture closure. Demographic information reported included age, parity, medical and surgical history, as well as fistula characteristics including size, location, presenting symptoms, and duration of symptoms. We describe our operative technique with picture description.This novel approach using a disposable punch biopsy device to complete excision of simple rectovaginal fistula tracts during a transvaginal rectovaginal fistula repair can help with achieving a successful surgical outcome.

SUBMITTER: Adelowo A

PROVIDER: S-EPMC3872741 | biostudies-literature | 2014 Jan-Feb

REPOSITORIES: biostudies-literature

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Rectovaginal fistula repair using a disposable biopsy punch.

Adelowo Amos A Ellerkmann Richard R Rosenblatt Peter P

Female pelvic medicine & reconstructive surgery 20140101 1

<h4>Objectives</h4>To describe a novel surgical technique for complete excision of a rectovaginal fistula tract using a disposable biopsy punch during a transvaginal rectovaginal fistula repair and to present our initial surgical experience.<h4>Methods</h4>Description of 4 cases of simple rectovaginal fistulas and an innovative surgical technique for the complete excision of the fistula tract using a disposable biopsy punch.<h4>Results</h4>Successful 3-, 9-, and 12-month follow-up of 4 cases wit ...[more]

PMID: 24368490

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Project description:PurposeTo determine the results after rectovaginal fistula (RVF) repair and find predictors of outcome. Primary objective was fistula healing. Secondary outcomes were morbidity and patient health-related quality of life (HRQoL).MethodAn observational study of 55 women who underwent RVF repair including both local procedures and tissue transposition 2003-2018 was performed. Baseline patient and fistula characteristics were registered, combined with a prospective HRQoL follow-up and a general questionnaire describing fistula symptoms.ResultsHealing rate after index surgery was 25.5% (n = 14) but the final healing rate was 67.3% (n = 37). Comparing the etiologies, traumatic fistulas (iatrogenic and obstetric) had the highest healing rates after index surgery (n = 11, 45.9%) and after repeated operations at final follow-up (n = 22, 91.7%) compared with fistulas of inflammatory fistulas (Crohn's disease, cryptoglandular infection, and anastomotic leakage) that had inferior healing rates after both index surgery (n = 7, 7.1%) and at final follow-up (n = 13, 46.4%). Fistulas of the category others (radiation damage and unknown etiology) included a small amount of patients with intermediate results at both index surgery (n = 1, 33.3%) and healing rate at last follow-up (n = 2, 66.7%). The differences were statistically significant for both index surgery (p = 0.004) and at final follow-up (p = 0.001). Unhealed patients scored lower than both healed patients and the normal population in 6/8 Rand-36 domains, but the differences were not statistically significant.ConclusionsMost traumatic rectovaginal fistulas closed after repeated surgery whereas inflammatory fistulas had a poor prognosis. Low healing rates after local repairs suggest that tissue transfer might be indicated more early in the treatment process. Unhealed fistulas were associated with reduced quality of life. Trial registration Clinicaltrials.gov No. NCT05006586.

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Rectovaginal fistula repair using a disposable biopsy punch.

Publications

Rectovaginal fistula repair using a disposable biopsy punch.

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