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Robot-Assisted VVF Repair Surgery

VVF (Vesicovaginal Fistula) is abnormal connections between the bladder and vagina. Doctors repair this fistula through transvaginal, transabdominal, laparoscopic, and robot-assisted approaches, chosen based on fistula size, location, and complexity. Robot-assisted VVF Repair has emerged as a highly successful surgical procedure. The robot-assisted approach offers significant advantages over traditional surgical methods. 

This comprehensive guide explores everything patients need to know about robot-assisted VVF repair, including its benefits, preparation requirements, surgical procedure details, and recovery expectations. It also covers important considerations such as insurance coverage and potential risks, helping readers make informed decisions about their treatment options.

Why CARE Group Hospitals is Your Top Choice for Robot-assisted VVF Repair Surgery in Hyderabad

CARE Hospitals stands at the forefront of robot-assisted surgical innovation in Hyderabad. Precision is paramount when dealing with vesicovaginal fistula repair, and CARE Hospitals delivers exceptional surgical accuracy. The surgical team at CARE Hospitals sets them apart from other facilities. Their extensively trained surgeons possess unmatched experience in both traditional and minimally invasive procedures. This expertise is vital for vesicovaginal fistula repair, requiring intricate surgical intervention and comprehensive post-operative care.

Patients benefit from CARE Hospitals' multidisciplinary approach, which is especially crucial for those with co-morbidities. Their holistic care system includes:

  • 24/7 imaging and laboratory services
  • Dedicated blood bank facilities
  • International infection control practices

Cutting-edge Surgical Innovations at CARE Hospitals

CARE Hospitals uses the da Vinci surgical system and the Hugo RAS system for robot-assisted VVF repair. These cutting-edge platforms provide surgeons with exceptional control during intricate procedures. 

Conditions for Robot-assisted VVF Repair Surgery

Vesicovaginal fistula (VVF) occurs when an abnormal connection forms between the bladder and vagina, causing continuous urinary leakage. This condition creates both physical discomfort and emotional distress for affected women. Robot-assisted VVF Repair becomes necessary under specific conditions where the fistula fails to heal naturally.

Despite attempts at non-surgical treatment like catheterisation and bed rest, many fistulas require surgical intervention when they don't close independently. Consequently, the robot-assisted approach offers a solution for restoring normal urinary continence.

Types of Robot-assisted VVF Repair Procedures

Surgical approaches for robot-assisted VVF Repair vary significantly among practitioners, with several distinct techniques showing promising results. One key difference in surgical technique involves ureteral protection strategies. Certain surgeons routinely place JJ stents during the procedure to safeguard the ureters, whereas others consider this unnecessary. This decision typically depends on the fistula's proximity to the ureteral openings and the surgeon's assessment of risk.

Know Your Procedure

This groundbreaking, minimally invasive approach repairs the abnormal connection between the bladder and vagina with precision and care.

Pre-surgery Preparation

Patients undergo a thorough evaluation before scheduling their robot-assisted VVF Repair. Initially, doctors identify the fistula through cystoscopy and physical examination. 

Complete bowel preparation typically occurs the day before surgery, including polyethylene glycol and a 4-5 litre liquid diet, although this is not absolutely necessary in all cases.

Robot-assisted VVF Repair Procedure

Key procedural steps include:

  • Placement of a high-definition 3D camera providing magnified visualisation
  • Careful mobilisation of the bladder from the vagina using sharp dissection
  • Removal of epithelialised edges of the fistulous tract
  • Single-layer closure of the vagina
  • Double-layer closure of the bladder using specialised sutures
  • The interposition of tissue (sigmoid epiploic appendage or peritoneal flap) between repairs
  • Water-tight testing of the repair via bladder filling

Post-surgery Recovery

Following robot-assisted VVF Repair, the drain typically remains for 24-48 hours and is removed once drainage is less than 50ml in 24 hours. Patients usually leave the hospital with an indwelling urethral catheter for continued bladder drainage, which typically stays in place for 10-14 days.

Risks and Complications

The main complication following any VVF repair is recurrent fistula formation, which requires careful consideration by both surgeon and patient.

Risk factors that increase the likelihood of VVF recurrence include:

  • Multiple fistulae (two or more)
  • Large fistula size (exceeding 10 mm)
  • Complex VVF involving the bladder, cervix or urethra
  • Presence of urinary tract infection
  • Obstetrical aetiology

Benefits Of Robot-Assisted VVF Repair Surgery

First and foremost, robot-assisted VVF Repair is a minimally invasive procedure that offers numerous advantages:

  • Smaller incisions and reduced tissue trauma
  • Less post-operative pain and discomfort
  • Shorter hospital stays (typically just 2 days)
  • Faster overall recovery times
  • Better cosmetic outcomes with minimal scarring
  • Reduced blood loss 
  • No need for blood transfusions in most cases

Insurance Assistance for Robot-assisted VVF Repair Surgery

Since 2019, the Insurance Regulatory & Development Authority of India (IRDAI) has mandated that all health insurance companies provide coverage for robot-assisted surgeries, including robot-assisted VVF Repair procedures. At CARE Hospitals, our dedicated staff helps navigate the insurance claiming process and pre-authorizes the robot-assisted VVF repair surgery claim.

Second Opinion for Robot-assisted VVF Repair Surgery

Seeking a second opinion remains a crucial step for patients considering robot-assisted VVF Repair surgery. Several scenarios justify obtaining another specialist's assessment:

  • Uncertainty about the diagnosis or proposed surgical approach
  • Complex or extensive fistulas requiring challenging repair
  • Previous unsuccessful repair attempts
  • Concerns about potential surgical risks
  • Desire to explore alternative surgical techniques

Conclusion

Robot-assisted VVF Repair stands as a remarkable advancement in treating vesicovaginal fistula. CARE Hospitals leads the way with cutting-edge robot-assisted systems and expert surgical teams. Their comprehensive approach ensures optimal outcomes through thorough pre-operative preparation, precise surgical execution, and dedicated post-operative care. Its impressive track record and patient satisfaction rates demonstrate the hospital's commitment to excellence.

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Frequently Asked Questions

Robot-assisted VVF repair is a minimally invasive surgical procedure used to correct a vesicovaginal fistula, which is an abnormal connection between the bladder and vagina

Robot-assisted VVF repair is considered a complex but less invasive procedure than traditional open surgery. 

Robot-assisted VVF repair has shown excellent success rates. The procedure is technically advanced but offers lower risk profiles than open surgery.

The most common cause necessitating robot-assisted VVF repair is previous pelvic surgery, particularly hysterectomy. Other causes include:

  • Childbirth trauma
  • Radiation therapy
  • Pelvic malignancies
  • Inflammatory bowel disease
  • Injuries to the bladder and vaginal wall

The duration of robot-assisted VVF repair typically ranges from 2 to 4 hours. 

The main complication is recurrent fistula formation, though this occurs in a small percentage of cases. Other possible risks include:

  • Ureteric injury or obstruction
  • Vaginal stenosis
  • Reduced bladder capacity
  • Irritative lower urinary tract symptoms
  • Stress incontinence 
  • Pain management issues
  • Infection at surgical sites

Patients often leave the hospital within 1-5 days after the procedure. Complete recovery continues at home, with the urinary catheter typically remaining in place for 10-14 days after surgery to allow proper healing.

Most patients experience less post-operative pain after robot-assisted VVF Repair compared to traditional open surgery.

Candidates for robot-assisted VVF Repair include women who have developed vesicovaginal fistula from various causes. 

Patients can gradually resume normal physical activities, including work and light exercises, within a few weeks after surgery.

Extended bed rest is not typically required following robot-assisted VVF Repair. Most patients begin ambulation on the same day as surgery or within 24 hours. 

Life after robot-assisted VVF Repair brings profound improvements for most women. Patients often experience immediate resolution of urinary leakage, which marks the end of a challenging period of incontinence. This successful closure of the abnormal connection typically leads to restored dignity and dramatically improved daily living.

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