Objective: Various newer techniques of refinement have come into the practice of vesicovaginal fistula (VVF) repairs, the most useful being the introduction of robot-assisted minimally invasive repairs. We aim to compare conventional laparoscopy and robot-assisted transabdominal VVF repairs through a prospective study assessing various parameters of surgical significance.Methods: All patients who underwent either laparoscopic or robot-assisted transabdominal VVF repairs, fitting inclusion/exclusion criteria, were included with random assignment to either group. The patients were evaluated for success rates and other perioperative parameters like operative time, estimated blood loss, length of hospital stay, abdominal drain duration, need for open conversion and complications.Results: A total of 40 patients underwent minimally invasive modified ‘o’ Conor VVF repair, with 20 each in both groups. Patients in both the groups were largely comparable based on their demographic data. Operative success rates between both groups were comparable, while statistically significant better outcomes were observed with the robotic group in the domains of operative duration (149.7±24.48 min vs. 228.7±28.63 min, ppp=0.003). Two patients in the laparoscopy arm had failure of procedure, while one had open surgical conversion. There were no major complications observed in both arms of the study.Conclusion: Robot-assisted VVF repairs seem to be a viable better option when compared to laparoscopic repairs, especially with the reduced patient morbidity, comparable operative success, superior perioperative outcomes and better surgical ergonomics.
Mittal et al. (Wed,) studied this question.