Robot-assisted repair of rectovesical fistula

Abstract

A 76-year-old man developed a rectovesical fistula after rectal resection for adenocarcinoma complicated by peritonitis with the necessity of the creation of a colostomy. The patient was undergone a rectosigmoidoscopy with the placement of clip-type Ovesco to close the fistula, but this technique resulted ineffective. A robot- assisted closure of the rectovesical fistula was performed using Xi Da Vinci System. The surgical procedure will be divided into 3 parts: longitudinal median cystotomy, excision of the fistula tract, and the closure of the anterior rectal wall and bladder with interposition of omentum, between the suture lines of the rectum and bladder, to prevent fistula recurrence. The patient removed the catheter after 4 weeks of surgery and the patient remained free of urinary leakage from the anus. In February 2021, the surgery for intestinal re-anastomosis was performed. Robotic surgery is a good approach for the treatment of rectovesical fistula when the endoscopic treatment was unresolving.

Keywords: Rectovesical fistula, prostate cancer, robotic-assisted surgery