A colorectal vesical fistula is a rare complication of radical prostatectomy, often presenting clinically challenging situations. In this study, we presented our experience using robotic technique for complex recurrent colorectal vesical fistula repair.

Our patient is a 57-year-old male who underwent a robotic-assisted radical prostatectomy for treatment of localized prostate cancer. However, the surgery was complicated with rectum injury intraoperatively and subsequent colorectal vesical fistula developed. Recurrent fistula even after multiple transanal and transperitoneal repair was still found. The patient presented with recurrent urinary tract infection and fecaluria. Consequently, surgical correction of transvesical robotic-assisted colorectal vesical fistulectomy and robotic-assisted low anterior resection were performed. The procedure was performed using the Da Vinci Xi system, and the operative techniques of fistulectomy were demonstrated via video.

The colorectal vesical fistula was successfully closed. The patient was discharged smoothly after 10 days of care. Post-operative cystography and cystography revealed: closure wound well healing with no recurrent fistula nor contrast leakage. The Foley catheter was smoothly removed during the one-month follow-up.

In this video, we present a technically challenging case of recurrent complex colorectal vesical fistula in a patient with a history of multiple repair surgery. The video showcases the enhanced benefits of greater visualization, precision, and dexterity offered by the robotic surgery system.

Continence 12S (2024) 101527
DOI: 10.1016/j.cont.2024.101527