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

Concept Vesicovaginal Fistula

Concept Transvaginal Repair

Concept Watertight Closure

Concept LATSCO

Concept LASCO

Session 182184

Keywords

LATSCO technique

transvaginal approach

vesicovaginal fistulas

laparoscopic hysterectomy

suturing

surgical video

fistula-vesicovaginal

surgery

fistula

PFD Week 2013

Vesicovaginal Fistula

Transvaginal Repair

Watertight Closure

LATSCO

LASCO

182184