Magtibay, Paul M.

Colovaginal and/or rectovaginal fistulas cause significant and distressing symptoms, including vaginitis, passage of flatus/feces through the vagina, and painful skin excoriation. These fistulas can be a challenging condition to treat. Although most fistulas can be treated with surgical repair, for those patients who are not operative candidates, limited options remain. As minimally-invasive interventional techniques have evolved, the possibility of fistula occlusion has enriched the therapeutic armamentarium for the treatment of these complex patients. In order to offer optimal treatment options to these patients, it is important to understand the imaging and anatomical features which may appropriately guide the surgeon and/or interventional radiologist during pre-procedural planning.

AbstractBackgroundThe objective of this research was to evaluate the feasibility of robotic nerve‐sparing radical parametrectomy for cervical cancer after simple hysterectomy.MethodsA 41 year‐old patient was diagnosed with invasive cervical adenocarcinoma after simple hysterectomy. Hysterectomy margins were negative. A robotic nerve‐sparing radical parametrectomy was offered and performed 5 weeks later.ResultsTotal operating time was 330 min, blood loss was 145 ml and length of hospitalization 2 days. Pathology revealed no residual tumour. Normal bladder function resumed on postoperative day 9. At a follow‐up of 16 months, the patient remains with no evidence of disease and with normal bladder and bowel function.ConclusionsRobotic nerve‐sparing radical parametrectomy is safe and feasible and can be offered to patients with indications for radical parametrectomy. Copyright © 2012 John Wiley & Sons, Ltd.