Advancement flap for treatment of colovaginal fistula after delayed colo‐anal anastomosis—A video vignette

This is the case of a 60-year-old female patient who had a history of low rectal adenocarcinoma with total neoadjuvant treatment and delayed coloanal anastomosis. One year later, a local recurrence was detected requiring resection of the coloanal anastomosis and creation of a new delayed coloanal anastomosis. Postoperative complications included abnormal vaginal discharge. Clinical examination confirmed a colovaginal fistula. A transverse diverting colostomy was performed as an initial management step. Video 1 demonstrates the transanal surgical repair of a colovaginal fistula following delayed coloanal anastomosis. The procedure involves careful dissection between the anterior wall of the colon and the posterior vaginal wall, complete excision of the fistulous tract and reconstruction using a colonic advancement flap, allowing the creation of a new coloanal anastomosis. Six months later, the patient had no recurrence of fistulous tract and reported good functional results. Barbara Noiret: Conceptualization; visualization; writing – original draft. Nathalie Villán-Ramirez: Conceptualization; writing – original draft; visualization. Eleni Andriopoulou: Writing – review and editing. Chee Hoe Koo: Writing – review and editing. Quentin Denost: Writing – review and editing; supervision. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors declare no conflicts of interest. The patient provided informed consent for the procedure and for the use of the video material for publication purposes. The data that support the findings of this study are available from the corresponding author upon reasonable request.