Combined Transabdominal and Transvaginal Repair of a Recurrent Rectovaginal Fistula Using Laparoscopic Omental Flap Interposition: A Case Report

Rectovaginal fistula (RVF) significantly reduces quality of life and almost always requires surgical excision, frequently followed by tissue reconstruction. Insufficient tissue volume and low blood supply may hinder direct repair and coverage of the fistula site, often necessitating tissue interposition techniques. An omental flap provides a robust blood supply to the rectovaginal septum and facilitates healing. We present a rare case of successful combined transabdominal and transvaginal repair of a large, complicated, recurrent low RVF using laparoscopic omental flap transposition, for which, to our knowledge, only a limited number of similar case has been reported. This case highlights the feasibility of combined abdominal and vaginal approaches with omental flap interposition for selected complex, recurrent RVFs.