TAMIS repair of rectovaginal fistula

Excerpt

Many techniques have been developed for the repair of RVFs. Among colorectal surgeons, endorectal advancement flaps are the most common procedure from a transanal approach, although there are technical differences between surgeons. This procedure involves the creation of a partial-thickness flap from the tissues in the rectal wall to cover the rectovaginal septum defect [1]. RVFs located far above the anal canal, require an intra-abdominal approach often due to technical difficulties related to poor access and visualization of the target as well as limited mobility of surgical instruments with a conventional transanal approach. Given the recent advances in minimally invasive colorectal surgery, these techniques have become of interest for the treatment of RVFs [2]. Transanal minimally invasive surgery (TAMIS) involves the use of a multichannel platform with a gas seal and standard laparoscopic instruments which enables the surgeon to easily access the confined rectal space to perform surgical repair with adequate view and enhanced surgical dexterity. …