2013 Annual Meeting-Transvaginal Approach to Vesicovaginal Fistula

Video Transcription

Video Summary

In this video, the LATSCO technique is used to demonstrate a simplified transvaginal approach to the surgical treatment of vesicovaginal fistulas. The case presented involves a patient who underwent a laparoscopic hysterectomy and later developed a fistula. The fistula is located and verified using cystoscopic evaluation and the bladder is backfilled with sterile water. The vaginal epithelium is injected with lidocaine with epinephrine, and a scalpel blade is used to incise the vaginal tissue around the fistula carefully. The epithelial edges are dissected off the underlying fibromuscular tissue using Alice clamps and medicine-bound scissors. The fistulous tract is excised, and the fibromuscular tissue is imbricated with sutures. Multiple layers of imbrication may be needed for a watertight closure. The vaginal epithelium is then closed using sutures. The video concludes by discussing the successful repair of vesicovaginal fistulas using this technique in a group of patients at their institution.

Meta Tag

Category surgical video

Category fistula-vesicovaginal

Category surgery

Category fistula

Category PFD Week 2013

Session 182184

Keywords

LATSCO technique

transvaginal approach

vesicovaginal fistulas

laparoscopic hysterectomy

suturing