PMC1266383_01
Schematic picture of the surgical procedure. A - Team positions. B - Picture showing RVF. C - RVF Dissected. D - Rectal and vaginal defects sutured separately.
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F1
Team position is diagrammatically represented in Figure 1A.
Port Positions and Intraoperative pictures. A - Port positions. B - Fistulous tract exposed. C - Fistulous opening on the vaginal side. D - Completion of repair.
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F2
Pneumoperitoneum was created with Veress needle. 10 mm ports were placed at the umbilicus for camera; in the right lower midclavicular line for right working hand and in the right upper midclavicular line for rectal retraction. 5 mm ports were placed in the left lower midclavicular line for left working hand and in the left iliac fossa for bladder retraction (Figure 2A). On retraction of the rectum, the dense fibrosis in the region of the fistula was identified which was divided with sharp scissors (Figure 2B). There was a 5 mm fistula between the vault of the vagina and the middle third rectum (Figure 2C). The vaginal side of the rent was also approximated with 2-0 Vicryl in single continuous layer (Figure 2D).