Robotic vesico-vaginal fistula repair with no omental flap interposition

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Introduction and hypothesis

A vesico-vaginal fistula (VVF) is a fistulous tract that connects bladder and vagina, causing urine leakage via the vagina. In the developed world, iatrogenic postoperative VVF is the most common case. Classically, when treating a VVF via the abdominal route, an abdominal flap is mobilized and interposed between the bladder and the vagina.


In our video, we describe a robotic VVF repair technique with no omental flap interpositioning for a vaginal vault-located fistula.


Duration of surgery was 95 min, estimated blood loss was <50 ml. The postoperative course was uneventful. At the 6-month follow-up, which included clinical and cystographic examinations, the patient had not experienced any recurrence.


In our opinion, a two-layered suturing technique using two semi-continuous sutures for vaginal closure and perpendicular interrupted stitches for bladder closure does not require omental flap mobilization, reducing operating time and possible complications related to accidental peritoneal injuries.

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Author information

Correspondence to Alberto Martini.

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Written informed consent was obtained from the patient for publication of this video article and any accompanying images.

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Martini, A., Dattolo, E., Frizzi, J. et al. Robotic vesico-vaginal fistula repair with no omental flap interposition. Int Urogynecol J 27, 1277–1278 (2016) doi:10.1007/s00192-016-2989-5

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  • Vesico-vaginal fistula
  • Robotic
  • Minimally invasive repair