Robotic Transanal Rectourethral Fistula Repair - a video vignette.

Surya Suhardja, Thomas; Errington, Belinda; Khalessi, Amirala; Phan-Thien, Kim-Chi

Acquired rectourethral fistula is an uncommon complication of treatment of rectal or prostate cancer1 . Perioperative radiotherapy has been associated with a more complex and persistent fistula2 . Cross-sectional imaging, with retrograde cystogram or pelvic magnetic resonance imaging, is usually sufficient to delineate the anatomy of the fistula with any associated collection, but can be aided by cystoscopy and sigmoidoscopy. Various surgical repairs (transanal, trans-sphincteric, transperineal and transabdominal) have been described with varying outcomes3 . The transanal approach is better suited for non-radiation or non-ablative induced fistulas4-10 . The rarity of this condition limits high quality evidence evaluating the surgical approach. The robotic platform has added benefit in providing superior ergonomics for the transanal approach. We present a case of robotic transanal rectourethral fistula repair.