Fig. 29.1
CT image showing vesico vaginal fistula
Fig. 29.2
Cystoscopic view showing a supra trigonal VVF
Fig. 29.3
Port position
Fig. 29.4
Adhesiolysis in progress
Fig. 29.5
Vertical cystotomy being done
Fig. 29.6
Cystotomy extended around fistula (Note preplaced ureteric catheter in fistula)
Fig. 29.7
Bladder mucosal incision around fistula
Fig. 29.8
Plane developed between posterior wall of bladder and anterior vaginal wall
Fig. 29.9
Fistula completely excised
Fig. 29.10
Vaginal rent closure with 3-0 PDS suture in progress
Fig. 29.11
Vaginal closure in progress
Fig. 29.12
Vaginal closure completed
Fig. 29.13
Omental interposition anterior to vagina
Fig. 29.14
Bladder closure started
Fig. 29.15
Bladder closure with 3-0 V Lock suture in continuous fashion
Fig. 29.16
Bladder closure in progress
29.6 Modification;1. Cystorrhaphy
Fig. 29.17
Bladder distended to look for any leak
Fig. 29.18
CT cystogram done 3 months later does not show any leak
Fig. 29.19
Cystoscopy showing the VVF in supratrigonal area following hysterectomy 1 week back
