• Erin Kelly, Maria Y Wu, and J Barry MacMillan.
• 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.
• J Robot Surg. 2018 Mar 1; 12 (1): 173-176.

BackgroundPost-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.CaseA 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.ConclusionWe 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.

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