Single Incision Laparoscopic Surgery for Sigmoid-vesical Fistula

Abstract

A 43-year-old man presented at our hospital with fever, abdominal pain and pneumaturia. Abdominal CT showed the abscess and the air between the urinary bladder and the sigmoid colon. Colonscopy revealed a diverticula in the sigmoid colon. Based on these findings, we diagnosed sigmoid-vesical fistula due to sigmoid diverticulitis.

As the patient with ankylosing spondylitis was maintained on prednisolone, we employed two-stage operative strategy. We performed Hartmannʼs operation and stoma closure by single incision laparoscopic surgery through stoma site. No complications or recurrence were seen following the fistulectomy. The single incision laparoscopic surgery through stoma site is found to be safe and feasible. And this enables us to improve the cosmesis and decrease the risk of surgical site infection.