Endoscopic closure of a rectovaginal fistula following surgery for endometriosis using the MARCEAU system
This study reports the first use of the MARCEAU endoscopic closure system to successfully treat a rectovaginal fistula following endometriosis surgery.
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This case report describes endoscopic closure of a rectovaginal fistula in a 31-year-old woman after colonic resection for endometriosis, using an ESD-assisted technique with the MARCEAU device. Sigmoidoscopy identified the rectal fistula orifice, surrounding mucosa was ablated by ESD to facilitate closure, and the MARCEAU device—an anti-return suture loop fixed and tightened with clips—was used to close the fistula; MRI at 3 months confirmed closure. The authors note that endoscopic closure strategies can be challenging and that technical success in their referenced experience for naïve fistulas did not exceed 70%, but this report’s evidence is limited to a single case without comparative outcomes. This paper is centrally about endometriosis — it reports a rectovaginal fistula occurring after surgery for endometriosis and its endoscopic closure using the MARCEAU system.
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