title: Endoscopy-assisted laparoscopic excision of rectourethral fistula in a male with imperforate anus.
abstract: We report a surgical technique that we developed to facilitate complete excision of rectourethral fistula (RUF)in male patients with imperforate anus (IA). A 6-month-old boy with rectobulbar urethral fistula (bulbar-RUF)had laparoscopic repair of IA. During laparoscopic dissection of the RUF, a fine flexible endoscope was inserted into the rectum through an opening made in the anterior rectal wall. Endoscopy of the rectum allowed the level of laparoscopic dissection to be observed intraluminally, allowing the bulbar-RUF to be excised exactly at its distal end. He is well after follow-up of 9 months with no evidence of residual RUF on radiologic investigations.We have since used this technique to treat another IA patient with prostatic-RUF successfully.
authors.affiliation: Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan. yama@med.juntendo.ac.jp
authors.forename: Atsuyuki
authors.initials: A
authors.lastname: Yamataka
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Kato
authors.forename: Kyeong Deok
authors.initials: KD
authors.lastname: Lee
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Lane
authors.forename: Junichi
authors.initials: J
authors.lastname: Kusafuka
authors.forename: Tadaharu
authors.initials: T
authors.lastname: Okazaki
mesh_terms: D001006:Anus, Imperforate / Q000150:complications*; D004724:Endoscopy; D006801:Humans; D007223:Infant; D010535:Laparoscopy; D008297:Male; D012003:Rectal Fistula / Q000601:surgery*; D014522:Urethral Diseases / Q000601:surgery*; D014548:Urinary Fistula / Q000601:surgery*