Technical advance

Laparoscopic repair of high rectovaginal fistula: Is it technically feasible?

Saravanan S Kumaran¹ , Chinnusamy Palanivelu² , Alfie J Kavalakat³ , Ramakrishnan Parthasarathi² and Murugayyan Neelayathatchi⁴

¹Department of Gastrointestinal Surgery, Gem Hospital, Coimbatore, India

²Department of Advanced Laparoscopic and Gastrointestinal Surgery, Gem Hospital, Coimbatore, India

³Department of Advanced Laparoscopic Surgery, Gem Hospital, Coimbatore, India

⁴Department of Endogynec Surgery, Gem Hospital, Coimbatore, India

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BMC Surgery 2005, 5:20doi:10.1186/1471-2482-5-20

Published:	12 October 2005

Abstract

Background

Rectovaginal fistula (RVF) is an epithelium-lined communication between the rectum and vagina. Most RVFs are acquired, the most common cause being obstetric trauma. Most of the high RVFs are repaired by conventional open surgery. Laparoscopic repair of RVF is rare and so far only one report is available in the literature.

Methods

We present a case of high RVF repaired by laparoscopy. 56-year-old female who had a high RVF following laparoscopic assisted vaginal hysterectomy was successfully operated laparoscopically. Here we describe the operative technique and briefly review the literature.

Results

The postoperative period of the patient was uneventful and after a follow up of 6 months no recurrence was found.

Conclusion

Laparoscopic repair of high RVF is feasible in selected patients but would require proper identification of tissue planes and good laparoscopic suturing technique.