Colovesical fistula – robotic-assisted laparoscopic anterior resection with fistula dissection

Abstract

Aim: Colovesical fistula is a rare complication of diverticular disease, which can result in recurrent urinary tract infections. Clinically suspected colovesical fistula can be confirmed by cross-sectional imaging and endoscopic assessment. Definitive treatment is by surgical resection of the colovesical fistula with colonic resection. Method: A 56-year-old man presented with abdominal pain, pneumaturia and fecaluria. CT colonoscopy confirmed the presence of a colovesical fistula secondary to sigmoid diverticular disease. Da Vinci XI robotic-assisted laparoscopic anterior resection with fistula dissection was performed. Results: Operative time was 4 h 21 min. Blood loss was 200 ml. Hospital stay was 6 days. No complications occurred. At 4-month follow-up, there was no clinical signs and symptoms suggestive of recurrent fistula. Conclusion: Robotic-assisted laparoscopic anterior resection with fistula dissection for colovesical fistula demonstrated good outcome. Although limited evidence, its use can be considered in selected patients.