Transanal Endoscopic Operation (TEO) Repair of Rectovaginal Fistula and Anastomotic Leakage: A Case Series

Introduction: interest in transanal endoscopic surgery has increased in the past decade. this approach facilitates both primary procedures such as polypectomy and local tumor excision as well as the treatment of postoperative complications including bleeding, leakage, and fistula formation. this study aimed to describe our group’s use of the transanal endoscopic operation (teo) in the repair of fistulae and anastomotic leakages, with the operations being led by an experienced surgeon (f.c.). case presentation: here, we describe three patients who developed postoperative complications after being subjected to anterior rectal resection. one of them developed a leakage of the anastomosis on the third postoperative day, while the others developed recurrent fistulae a long time after the surgery. these complications were all treated via teo. in one case, the transanal procedure was performed three times because of the recurrence of the fistula. in another case, it was associated with laparoscopy to treat peritonitis that occurred secondary to anastomotic disruption. in the last case, the patient had a history of years of fistula recurrence associated with pelvic abscess, and the teo approach proved to be determinant in the resolution of the problem. in all cases, the transanal surgery definitively repaired the defect; the patients were discharged and, to date, remain without recurrence. conclusion: in the hands of experienced surgeons and for selected cases, teo appears to be a valid option for treating postoperative complications, such as fistulae and anastomotic leakage. this procedure averts the need for major surgery associated with greater morbidity and shows excellent results.