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Session:: Ongoing Videos

V79 - Robotic-Assisted Sigmoid Colectomy with Colovaginal Fistula Closure and Intracorporeal Colorectal Anastomosis.

Saturday, May 9, 2026
On-Demand

    Video Presentation(s)

  • Aniket Maini, BS (he/him/his)

    Medical Student
    UMass Chan Medical School
    UMass Chan Medical School
    Worcester, MA, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • Andrew Hu, MD

    General Surgery Resident
    UMass Chan Medical School
    University of Massachusetts T.H Chan Medical School
    Worcester, MA, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • Benjamin Gallant, MD

    General Surgery Resident
    UMass Chan Medical School
    UMass Chan Medical School
    Worcester, MA, United States

    Disclosure information not submitted.

  • FH

    Frances Y. Hu, MD, MSc

    colorectal surgeon
    Georgia Colon & Rectal Surgical Associates
    Atlanta, Georgia, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • TP

    Thomas Peponis, MD, FACS

    Colon and Rectal Surgeon, Assistant Professor of Surgery
    University of Massachusetts
    Worcester, Massachusetts, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.
Aniket Maini, B.S.: This individual has no financial relationships with ineligible companies.
Andrew Hu, MD: This individual has no financial relationships with ineligible companies.
Thomas Peponis, MD, FACS: This individual has no financial relationships with ineligible companies.
Purpose/Background: We present a case of a robotic-assisted sigmoid colectomy with colovaginal fistula closure in a 78 year old female with remote history of hysterectomy and recent diverticulitis.

Methods/Interventions: The patient was referred to our clinic with feculent vaginal discharge. She had a previous transvaginal hysterectomy. Axial imaging revealed thickening of the sigmoid colon that was abutting the vagina as well as stool in the vaginal vault suggesting an underlying colovaginal fistula. Colonoscopy ruled out colonic malignancy. Vaginal exam was unremarkable with the exception of feculent discharge. She was taken to the operating room for a robotic-assisted sigmoid colectomy. . The colovaginal fistula was divided and the inflammatory rind on the vaginal cuff was debrided. The left colon was mobilized for a tension free anastomosis. A side-to-end intracorporeal colorectal anastomosis was done. An omental pedicled flap was then used to close the vaginal end of the fistula.

Results/Outcomes: Postoperative pathology revealed diverticular disease with a transmural defect consistent with perforation/fistula formation. The patient tolerated the procedure well and had return of bowel function on postoperative day 2. She had complete resolution of her prior symptoms at the postoperative clinic visit.

Conclusion/Discussion: This video demonstrates a minimally invasive technique that can lead to excellent outcomes in patients with colovaginal fistula secondary to diverticulitis.