ArticleSurgical endoscopy2025
Diverticular disease complicated by colovesical and colovaginal fistulas: not so complex robotically.
Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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Who cites it
4 citing papers in PubMed.
- Surgical and clinical predictors of successful Hartmann reversal procedure after perforated diverticulitis.Surgical endoscopy · 2026Observational
- Single-surgeon learning curve for robotic-assisted transabdominal retromuscular repair with Hugo RAS™ surgical system.Surgical endoscopy · 2026Article
- Article
- Comparison of Open Versus Minimally Invasive Repair of Colovesical Fistula: A Case Report and Propensity-Matched National Database Analysis.Journal of clinical medicine · 2025Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionFistulizing diverticulitis occurs in only 2% of diverticular disease cases, but its symptoms, such as urinary tract infections (UTI), pneumaturia, fecaluria, or vaginal discharge, are highly disruptive to patients. Therefore, surgery is commonly recommended. Laparoscopy has been proven feasible and safe for fistulizing diverticulitis, although revealing a conversion rate of 36%. Robotic surgery might reduce the conversion rate due to advanced instrumentation and improved optics.
methodsAll consecutive patients diagnosed with diverticulitis complicated by a colovesical or/and colovaginal fistula who underwent robotic surgical resection at Mayo Clinic Rochester (January 2018-June 2024) were included. Exclusion criteria were concurrent Crohn's disease, colorectal cancer, isolated coloovarian fistula, and less than one month of follow-up.
resultsEighty-nine patients were included in the study: fifty-eight (65%) patients presented with a colovesical fistula, 26 (29%) patients with a colovaginal fistula, and 5 (6%) patients with both. Ureteral ICG was utilized in 44% of cases. There were no intraoperative complications and one conversion secondary to loss of planes. Fourteen (16%) and 8 (9%) received an end colostomy or a loop ileostomy, respectively. Overall, 30-days complications were 35%, with anastomotic leak and abscess occurring in 3% and 6% of cases, respectively. One patient experienced a postoperative bladder leak, managed with a Foley catheter for 14 days, leaving no sequelae. With a median follow-up of 16.5 months, one (1%) fistula recurred after 14 days.
conclusionsRobotic surgery for fistulizing diverticulitis is feasible, with an acceptable complication rate and extremely low conversion and recurrence rates.
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