Please use this identifier to cite or link to this item: http://repositorio.unicamp.br/jspui/handle/REPOSIP/355559
Type: Artigo
Title: Transanal minimally invasive surgery (TAMIS) to treat vesicorectal fistula: a new approach
Author: Tobias-Machado, Marcos
Mattos, Pablo Aloisio Lima
Reis, Leonardo Oliveira
Juliano, César Augusto Braz
Pompeo, Antonio Carlos Lima
Abstract: Vesicorectal fistula is one of the most devastating postoperative complications after radical prostatectomy. Definitive treatment is difficult due to morbidity and recurrence. Despite many options, there is not an unanimous accepted approach. This article aimed to report a new minimally invasive approach as an option to reconstructive surgery. Materials and Methods: We report on Transanal Minimally Invasive Surgery (TAMIS) with miniLap devices for instrumentation in a 65 year old patient presenting with vesicorectal fistula after radical prostatectomy. We used Alexis® device for transanal access and 3, 5 and 11 mm triangulated ports for the procedure. The surgical steps were as follows: cystoscopy and implant of guide wire through fistula; patient at jack-knife position; transanal access; Identification of the fistula; dissection; vesical wall closure; injection of fibrin glue in defect; rectal wall closure. Results: The operative time was 240 minutes, with 120 minutes for reconstruction. No perioperative complications or conversion were observed. Hospital stay was two days and catheters were removed at four weeks. No recurrence was observed. Conclusions: This approach has low morbidity and is feasible. The main difficulties consisted in maintaining luminal dilation, instrumental manipulation and suturing
Subject: Fístula
Country: Brasil
Editor: Sociedade Brasileira de Urologia
Rights: Aberto
Identifier DOI: 10.1590/S1677-5538.IBJU.2014.0002
Address: https://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382015000501020
Date Issue: 2015
Appears in Collections:FCM - Artigos e Outros Documentos

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