Browse
Submit Data
Databases
API
Help

Dataset Information

0 Views

0 Connections

0 Citations

0 Reanalyses

0 Downloads

Omics score: 0

Surgical Approach for Repair of Rectovaginal Fistula by Modified Martius Flap.

ABSTRACT: Rectovaginal fistulas (RVF) are rare but represent a challenge for both patients and surgeons. The most common cause of RVF is obstetric trauma, and treatment is based on fistula classification and localization of the fistula in relation to the vagina and rectum. Conventional therapy frequently fails, making surgery the most viable approach for fistula repair. One surgical procedure which offers adequate repair of lower and middle rectovaginal fistulas consists of interposition of a bulbocavernosus fat flap also called modified Martius flap. First described by Heinrich Martius in 1928, this approach has been continuously modified and adjusted over time and is used in the repair of various pelvic floor disorders. Overall success rates reported in the literature of the interposition of a Martius flap as an adjunct procedure in the surgical management of RVF are 65-100 %. We present a detailed description of the operation technique together with a discussion of the use of a dorsal-flapped modified Martius flap in the treatment of RVF.

SUBMITTER: Reichert M

PROVIDER: S-EPMC4210382 | biostudies-other | 2014 Oct

REPOSITORIES: biostudies-other

ACCESS DATA

Json Xml

Similar Datasets

A Toolbox of Surgical Techniques for Palatal Fistula Repair.

Project description:ObjectiveTo provide an inventory of oronasal fistula repair techniques alongside expert commentary on which techniques are appropriate for each fistula type.DesignA 4-stage approach was used to develop a consensus on surgical techniques available for fistula repair: (1) in-person discussion of oronasal fistula cases among cleft surgeons, (2) development of a schema for fistula management using transcripts of the in-person case discussion, (3) evaluation of the preliminary schema via a web-based survey of additional cleft surgeons, and (4) revision of the management schema using survey responses.ParticipantsSix cleft surgeons participated in the in-person case discussion. Eleven additional surgeons participated in the web-based survey. Participants had diverse training experiences, having completed residency and fellowship at 20 different hospitals.ResultsA schema for fistula management was developed, organized by fistula location. The schema catalogues all viable approaches for each location. For fistulae involving the soft palate, the schema stresses the importance of evaluating for velopharyngeal insufficiency (VPI) and incorporating VPI management into fistula repair. For fistulae involving the hard palate, the schema separately enumerates the techniques available for nasal lining repair and for oral lining repair in each region. The schema also catalogues the diversity of approaches to lingual- and labioalveolar fistula, including variation in timing, orthodontic preparation, and simultaneous alveolar bone grafting.ConclusionsThis study employed consensus methods to create a comprehensive inventory of available fistula repair techniques and to identify preferential techniques among a diverse group of surgeons.

| S-EPMC8150164 | biostudies-literature

Surgical repair of hepatic hydrothorax caused by diaphragmatic fistula.

Project description:A 65-year-old woman visited our hospital complaining of dyspnea several days before admission. A chest X-ray showed massive right-sided pleural effusion, which was not observed 1 month previously. Although the patient had never been diagnosed with cirrhosis at regular visits, the patient was diagnosed with primary biliary cholangitis at admission. Hepatic hydrothorax was suspected because pleural effusion was transudative. A diaphragmatic fistula was confirmed and closed by thoracoscopy. Pleural effusion did not reappear after this procedure. Existence of a diaphragmatic defect should be confirmed under direct vision if pleural effusion accumulates acutely or becomes beyond control.

| S-EPMC7773676 | biostudies-literature

Vertical rectus abdominis myocutaneous free flap repair of post-pneumonectomy bronchopleural fistula: a case report.

Project description:BackgroundBronchopleural fistula (BPF) is a seldom encountered yet serious complication after thoracic surgery, and is often difficult to treat. Large BPFs usually require surgical intervention, and a variety of different surgical reconstruction options have been previously described. This case report presents the first description of a successful vertical rectus abdominis myocutaneous (VRAM) free flap repair of a BPF after pneumonectomy.Case descriptionA 46-year-old male with a cough was found to have a right upper lobe lung mass with hilar involvement initially remarkable for epithelioid malignant mesothelioma on biopsy. After neoadjuvant chemotherapy, he underwent right extrapleural pneumonectomy and developed a late right mainstem BPF with associated empyema from adjuvant chemotherapy and COVID-19 pneumonia. He was treated with open Clagett window (OCW) to address the infection and then staged VRAM free flap coverage of the BPF. The patient recovered successfully and has since been able to pursue more demanding activities at home.ConclusionsThis case presents the only successful VRAM free flap for a BPF involving the entire right mainstem bronchus at the carina. VRAM free flap repair offers a useful treatment option for BPFs, especially in patients with large pleural cavity defects.

| S-EPMC9634460 | biostudies-literature

Complex two-stage open surgical repair of an aortoesophageal fistula after thoracic endovascular aortic repair.

Project description:Aortoesophageal fistula after thoracic endovascular aortic repair is a rare but fatal complication, and no clear guidelines exist in the literature for optimal management. Herein, we report a complex case of a patient with an infected thoracic endograft that led to an aortoesophageal fistula. The treatment comprised a two-stage open surgical approach-an extra-anatomic aortic bypass in the first stage, followed by explantation of the infected endograft with ligation of the descending thoracic aorta in the second. This approach controls the focus of infection while allowing flow to the aorta distal to the infected endograft, minimizing visceral ischemia time.

| S-EPMC6601018 | biostudies-literature

Surgical Approach to Urethral Diverticulum and Urethrovaginal Fistula With Mesh Erosion.

Project description:Introduction and hypothesisThis video illustrates a rare surgical case involving a urethral diverticulum, urethrovaginal fistula, and mesh erosion.MethodsWe present a 58-year-old patient attending a tertiary care center with a suspected urethrovaginal fistula. Her concerns included stress urinary incontinence (SUI), recurrent urinary tract infection, and vaginal pain. The surgical history was notable for the placement of two different mesh slings during the same procedure to treat SUI. Preoperative evaluation and findings are illustrated in detail. The video uses a high-definition surgical camera to emphasize the initial intraoperative evaluation with localization of the fistula and diverticulum. We then demonstrate the approach to the dissection with the goal of ensuring complete resection of the diverticulum, fistula, and mesh, while preserving healthy tissue for subsequent closure. The utilization of unique and specialized tools for each portion of the procedure is also illustrated. A layered vaginal closure, including a Martius flap, is created to prevent recurrence.ResultsThe surgery was accomplished without complications.ConclusionsTo our knowledge, concomitant findings of a urethral diverticulum, urethrovaginal fistula, and mesh erosion are unique in the literature. We postulate that this triad could have resulted from the mesh burden in this particular patient.

| S-EPMC11245446 | biostudies-literature

Surgical technique for atrial-esophageal fistula repair after catheter ablation: An underrecognized complication.

Project description: Not available

| S-EPMC8303005 | biostudies-literature

An Innovative Single Staged Surgical Repair of Benign Tracheoesophageal Fistula – A Case Report

Project description:Tracheo-oesophageal fistula (TOF) is defined as a pathological connection between the trachea and the oesophagus, leading to a spillover of oral and gastric secretions into the respiratory tract causing aspiration. The cause of TOF may be congenital or acquired. In this case report, a 48 years old female with acquired TOF, has been reported. The patient was on ventilator support for COVID-associated pneumonia and its complication with endotracheal tube for 3 weeks and then tracheostomy was done. Post recovery after weaning from the ventilator, the patient was diagnosed with TOF by bronchoscopy and confirmed by CT and MRI. Surgical closure was performed: the oesophageal defect was sutured in 2 layers and Tracheal wall was isolated and a pedicled strap muscle flap sutured into the defect between the trachea and esophagus. The etiology of TOF may be due to traumatic intubation, cuff pressure, or inflammation. A better knowledge about the cause, site, and size of the TOF will help in prompt surgical procedure and recovery of the patient. This single staged surgical closure can be safely performed in the majority of patients with acquired TOF for optimal outcomes. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-022-03382-w.

| S-EPMC10155128 | biostudies-literature

Hybrid approach to neonatal repair of large symptomatic congenital coronary artery fistula.

Project description: Not available

| S-EPMC8305290 | biostudies-literature

Hybrid approach to neonatal repair of large symptomatic congenital coronary artery fistula.

Project description: Not available

| S-EPMC8305290 | biostudies-literature

Hybrid approach to neonatal repair of large symptomatic congenital coronary artery fistula.

Project description: Not available

| S-EPMC8305290 | biostudies-literature