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Video

Session: Ongoing Videos for CME

VM48 - Salvage Robotic Deloyers Procedure with taTME for Symptomatic Colovaginal Fistula

Saturday, June 1, 2024
10:00 AM – 1:30 PM ET, USA
Location: Baltimore Convention Center, Hall BCD

    Video Presentation(s)

  • Morgan E. Jones, MBBS, BSc (Hons)

    General Surgery Registrar
    Alfred Health, Melbourne, Australia
    Alfred Health
    Melbourne, Victoria, Australia

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • GT

    Greg Turner, MB ChB, MMedSc, FRACS

    Colorectal Surgery Fellow
    Peter MacCallum Cancer Centre
    Melbourne, Victoria, Australia

    Disclosure information not submitted.

  • Amrish KS Rajkomar, MBBS, BMedSci

    Colorectal research fellow
    Division of Cancer Surgery, Division of Cancer Research, Peter MacCallum Cancer Centre, Melbourne, Australia
    University of Melbourne
    Melbourne, Victoria, Australia

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • HA

    Heriot G. Alexander, MD, MBA, FRACS, FRCS

    Colorectal Surgeon
    Division of Cancer Surgery, Division of Cancer Research, Peter MacCallum Cancer Centre, Melbourne, Australia
    Melbourne, Victoria, Australia

    Disclosure information not submitted.

    • Senior Author(s)

  • SW

    Satish K. Warrier, MBBS, FRACS

    Colorectal Surgeon
    Department of General Surgery, The Alfred Hospital, Melbourne, Australia, Division of Cancer Surgery, Division of Cancer Research, Peter MacCallum Cancer Centre, Melbourne, Australia
    Melbourne, Victoria, Australia

    Disclosure information not submitted.

Purpose/Background: Colovaginal fistulae or other anastomotic complications following ultralow anterior resection are often treated with excision and permanent colostomy. We describe a novel approach for treating a symptomatic colovaginal fistula following an ultralow anterior resection with a robotic taTME and Deloyers procedure.

Methods/Interventions: We adopt a totally robotic approach to this case with a TaTME and Deloyers procedure. The TaTME allows for improved resection of the fibrotic segment of pelvic tissue to overcome the technical limitations encountered abdominally. The utilisation of ICG ensures no ureteric injury and confirms colonic perfusion in real time.

Results/Outcomes: The patient suffered no complications and the anastomosis was intact at 6 weeks. The ileostomy has been reversed and at 6 months the patient is doing well.

Conclusion/Discussion: To our knowledge, this is the first time a totally robotic TaTME and Deloyers Procedure has been described.
This case demonstrates both that reconstruction can be considered in chronic pelvic cases previously thought not to be reconstructable and that a totally robotic approach is both feasible and safe.