Robotic Assisted Laparoscopic Repair of Vesicovaginal Fistula Secondary to a Large Retained Foreign Body

Objective: To report our first experience in transperitoneal laparoscopic repair of vesicovaginal fistula in Dr. Hasan Sadikin Hospital. Method: A 31-year-old female presented with vesicovaginal fistula after cesarean section. Patient complained of urinary incontinence since 5 years ago. After a failed trial of conservative treatment with catheter drainage, a transperitoneal laparoscopic repair was performed. Initially, cystoscopy was performed to confirm the fistula location and for bilateral ureteric catheterization. A 4-port technique was performed with the patient in lithotomy position and slightly Trendelenburg. Without opening the bladder, the fistula tract was excised and the bladder was separated from the anterior vaginal wall. Both the bladder and vaginal walls were then closed separately using intracorporeal suturing, interposed with the omentum. Result: Total operative time was 270 minutes. Normal diet was resumed on day 1, drain was removed on the first day after surgery, and the patient was discharged on the second day with an indwelling catheter. Surgical wound showed good cosmetic result and no leakage was identified from cystogram after 2 weeks. The catheter was removed after 2 weeks. Conclusion: Laparoscopic transperitoneal repair of vesicovaginal fistula with omentum inteposition is feasible in Dr. Hasan Sadikin Hospital with good outcome, short hospital stay, and good cosmetic result. [Indones J Obstet Gynecol 2014; 4: 223-225] Keywords: laparoscopy, vesicovaginal fistula

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Accuracy of ultrasonography in detecting radiolucent soft-tissue foreign bodies

Indian Journal of Radiology and Imaging ◽

10.1055/s-0041-1734408 ◽

2014 ◽

Vol 24 (02) ◽

pp. 196-200

Author(s):

Morteza Tahmasebi ◽

Hamdollah Zareizadeh ◽

Azim Motamedfar

Keyword(s):

Foreign Body ◽

Soft Tissue ◽

High Frequency ◽

Foreign Bodies ◽

Linear Array ◽

Foreign Body Removal ◽

Retained Foreign Body ◽

Array Transducer ◽

Highly Sensitive ◽

Objective Detection

Abstract Background and Objective: Detection of radiolucent soft-tissue foreign bodies is a challenging problem, which is especially further complicated when retained foreign body is highly suggested by clinicians but radiography is negative. So, blind exploration is sometimes hazardous for patients. The purpose of this study was to determine the accuracy of ultrasonography (USG) in detecting radiolucent soft-tissue foreign bodies in the extremities. Materials and Methods: From November 2011 to January 2012, patients with clinically suspected radiolucent soft-tissue foreign body and negative radiography were evaluated by USG with a 12-MHz linear array transducer. The patients with positive clinical and USG examination were included in our study and underwent exploration or USG removal. Results: Fifty-one patients underwent foreign body removal under ultrasonography-guided or surgical exploration and 47 patients had foreign body (31, 12, 3, and 1 case had thorn, wood, glass, and plastic, respectively). Ultrasound was positive in 50 patients. USG falsely predicted the presence of foreign body in four cases and was falsely negative in one of the cases. Accuracy, sensitivity, and positive predictive value were determined as 90.2%, 97.9%, and 92%, respectively. Conclusions: The real-time high-frequency USG is a highly sensitive and accurate tool for detecting and removing radiolucent foreign bodies which are difficult to be visualized by routine radiography.

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