title: Robotic-assisted vesicovaginal fistula repair using an extravesical approach without interposition grafting.
abstract: BACKGROUND
  Post-hysterectomy vesicovaginal fistula (VVF) is rare. In addition to conventional abdominal and vaginal approaches, robotic-assisted VVF repairs have recently been described. We present a case of an extravesical, robotic-assisted VVF repair, without placement of an interposition graft performed in a Canadian teaching center.
  
  
  METHODS
  A 51-year-old woman presented with urinary incontinence 5 days after laparoscopic hysterectomy. Computed tomography cystogram, cystoscopy, and methylene blue dye test, confirmed a VVF above the bladder trigone. The patient underwent a robotic-assisted VVF repair 3 months after presentation, without complication. An abdominal, extravesical approach was used. Operative time was 116 min and repeat CT cystogram showed no evidence of persistent.
  
  
  CONCLUSIONS
  We have demonstrated that a VVF repair, using a robotic-assisted, extravesical approach without interposition graft placement, can be safe, less invasive and have a successful outcome at 1 year of follow-up.
authors.affiliation: Division of Urogynecology, Department of Obstetrics and Gynecology, London Health Sciences Centre, Victoria Campus, Western University, Room B2 401, 800 Commissioners Road East, London, ON, N6H 5W9, Canada. Erin.Kelly@londonhospitals.ca.
authors.forename: Erin
authors.initials: E
authors.lastname: Kelly
authors.affiliation: Division of Urogynecology, Department of Obstetrics and Gynecology, London Health Sciences Centre, Victoria Campus, Western University, Room B2 401, 800 Commissioners Road East, London, ON, N6H 5W9, Canada.
authors.forename: Maria Y
authors.initials: MY
authors.lastname: Wu
authors.affiliation: Division of Urogynecology, Department of Obstetrics and Gynecology, London Health Sciences Centre, Victoria Campus, Western University, Room B2 401, 800 Commissioners Road East, London, ON, N6H 5W9, Canada.
authors.forename: J Barry
authors.initials: JB
authors.lastname: MacMillan
mesh_terms: D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D061646:Operative Time; D065287:Robotic Surgical Procedures / Q000379:methods*; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology / Q000601:surgery; D014719:Vesicovaginal Fistula / Q000601:surgery*
keywords: Laparoscopic; Robotics; Vesicovaginal fistula