title: Robotic vesico-vaginal fistula repair with no omental flap interposition.
abstract: OBJECTIVE
  A vesico-vaginal fistula (VVF) is a fistulous tract that connects bladder and vagina, causing urine leakage via the vagina. In the developed world, iatrogenic postoperative VVF is the most common case. Classically, when treating a VVF via the abdominal route, an abdominal flap is mobilized and interposed between the bladder and the vagina.
  
  
  METHODS
  In our video, we describe a robotic VVF repair technique with no omental flap interpositioning for a vaginal vault-located fistula.
  
  
  RESULTS
  Duration of surgery was 95 min, estimated blood loss was <50 ml. The postoperative course was uneventful. At the 6-month follow-up, which included clinical and cystographic examinations, the patient had not experienced any recurrence.
  
  
  CONCLUSIONS
  In our opinion, a two-layered suturing technique using two semi-continuous sutures for vaginal closure and perpendicular interrupted stitches for bladder closure does not require omental flap mobilization, reducing operating time and possible complications related to accidental peritoneal injuries.
authors.affiliation: Department of Urology, University of Florence, Careggi Hospital, Viale San Luca, 50134, Florence, Italy. a.martini.md@gmail.com.
authors.forename: Alberto
authors.identifier: http://orcid.org/0000-0003-1272-7154
authors.initials: A
authors.lastname: Martini
authors.affiliation: Department of Urology, University of Florence, Careggi Hospital, Viale San Luca, 50134, Florence, Italy.
authors.forename: Eugenio
authors.initials: E
authors.lastname: Dattolo
authors.affiliation: Department of Urology, University of Florence, Careggi Hospital, Viale San Luca, 50134, Florence, Italy.
authors.forename: Jacopo
authors.initials: J
authors.lastname: Frizzi
authors.affiliation: Department of Urology, University of Florence, Careggi Hospital, Viale San Luca, 50134, Florence, Italy.
authors.forename: Donata
authors.initials: D
authors.lastname: Villari
authors.affiliation: Department of Urology, University of Florence, Careggi Hospital, Viale San Luca, 50134, Florence, Italy.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Paoletti
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D009852:Omentum / Q000637:transplantation; D061646:Operative Time; D065287:Robotic Surgical Procedures / Q000379:methods*; D013524:Surgical Flaps; D013536:Suture Techniques; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000601:surgery; D013520:Urologic Surgical Procedures / Q000379:methods*; D014621:Vagina / Q000601:surgery; D014719:Vesicovaginal Fistula / Q000601:surgery*
keywords: Minimally invasive repair; Robotic; Vesico-vaginal fistula