Dual-Endoscopic Surgical Repair for Rectovaginal Fistula

Background Rectovaginal fistula (RVF) is an abnormal connection between the rectum and vagina that causes significant physical discomfort and psychosocial distress. Conventional surgical treatments often involve substantial trauma and variable success rates. Methods This prospective study evaluated an innovative dual-cavity endoscopic repair technique in 5 RVF patients (3 low, 1 mid, and 1 high fistulas). The procedure combined endoscopic clip placement with argon plasma coagulation, performed under conscious sedation. Key technical aspects included transrectal and transvaginal access, mucosal needle hole creation, and purse-string suture closure. Results Complete anatomical healing was achieved in all cases (100%), confirmed by 3-month endoscopic and barium enema follow-up. The mean operative time was 94.2 ± 53.73 minutes with no intraoperative complications. Postoperative outcomes included:Zero cases of bleeding, infection, or sphincter dysfunction Mean hospital stay of 3.4 ± 0.55 days Full diet tolerance within 24 hours post-procedure All patients reported resolution of vaginal discharge and maintained healing at 6-month follow-up. Conclusions The dual-cavity endoscopic approach demonstrates excellent efficacy and safety for RVF repair across anatomical subtypes. Compared to traditional surgeries, this technique offers advantages of minimal invasiveness, sphincter preservation, and rapid recovery. These findings support its consideration as a primary treatment option, though larger studies are needed to confirm long-term outcomes.