What exactly is a rectovaginal fistula?

A rectovaginal fistula (RVF) is an abnormal connection between the rectum and the vagina. This condition can arise after rectal cancer resection. This can lead to symptoms like fecal incontinence and gas passage through the vagina.

Can you explain the modified Martius graft technique for rectovaginal fistula repair?

The modified Martius graft technique combines the LIFT (ligation of intersphincteric fistula tract) procedure with a Martius graft. First the fistulous tract is located and ligated. Then a Martius graft (pedicled labial fat pad) is harvested and placed between the rectum and vagina to reinforce the closure.

What makes the Martius graft so important in this repair technique?

The Martius graft is significant because it provides healthy, well-vascularized tissue to reinforce the repair of the rectovaginal fistula. By interposing this graft between the rectum and vagina, it helps to create a barrier against recurrence and promotes healing of the tissues.

How does the LIFT procedure relate to the modified Martius graft technique?

The LIFT procedure (ligation of intersphincteric fistula tract) plays a role in the modified Martius graft technique by helping surgeons precisely identify and ligate (tie off) the fistulous tract. This disruption of the abnormal connection is a critical first step in the repair process.

What are the advantages of using the modified Martius graft technique?

The benefits of the modified Martius graft technique include being less invasive compared to traditional methods, providing enhanced tissue support for healing, and potentially reducing the risk of fistula recurrence. These factors can lead to improved patient outcomes and quality of life.

Symbolic illustration of rectovaginal fistula repair with a flower emerging from healed tissue.

Rectovaginal Fistula Repair: A Simple, Safe Technique You Need to Know

Jordan Keane in Health & Wellness December 2025 • 4 min read.

"Discover how a modified Martius graft offers a promising solution for rectovaginal fistula repair after rectal cancer resection."

Rectovaginal fistulas (RVFs) are an uncommon yet distressing complication that can arise after rectal cancer resection. These abnormal connections between the rectum and vagina can lead to significant discomfort, impacting a woman's quality of life and overall well-being. Symptoms can include fecal incontinence, gas passage through the vagina, and recurrent infections, making everyday activities a source of anxiety.

Traditional approaches to RVF repair often involve complex surgical procedures with varying success rates. Recognizing the need for simpler, more effective solutions, surgeons are constantly exploring innovative techniques to address this challenging condition. One such technique, drawing inspiration from the LIFT (ligation of intersphincteric fistula tract) procedure, involves identifying and ligating the fistulous tract, followed by reinforcement with a modified Martius graft.

This article delves into this promising technique, highlighting its potential benefits and offering insights into how it can help women regain control and confidence after rectal cancer treatment. We'll explore the steps involved, the advantages it offers, and the real-world outcomes that demonstrate its effectiveness.

Understanding the Modified Martius Graft Technique for RVF Repair

Symbolic illustration of rectovaginal fistula repair with a flower emerging from healed tissue.

The modified Martius graft technique, as described by Uribe N, Balciscueta Z, Martin MC, Lopez M, Tabet M, and Torrijo I, offers a novel approach to rectovaginal fistula repair. It combines the principles of the LIFT procedure with the use of a Martius graft, a well-established technique in reconstructive surgery. Here's a breakdown of the key steps:

Fistula Identification and Ligation: This initial step involves carefully locating the fistulous tract, the abnormal connection between the rectum and vagina. Surgeons draw upon the LIFT procedure, aiming to precisely identify and then ligate (tie off) the tract to disrupt the connection.

2. Martius Graft Preparation: A Martius graft, typically a pedicled labial fat pad, is harvested. In this modified technique, the graft is carefully prepared to ensure adequate size and blood supply for successful interposition.
3. Posterior Interposition: The prepared Martius graft is then strategically positioned between the rectum and vagina, effectively interposing a layer of healthy, well-vascularized tissue to reinforce the closure and promote healing. This interposition helps to create a barrier against recurrence.

This combined approach offers several potential advantages, including a less invasive approach compared to some traditional methods, enhanced tissue support for healing, and a reduced risk of fistula recurrence.

A Promising Solution for a Challenging Condition

The modified Martius graft technique represents a promising advancement in the treatment of rectovaginal fistulas. By combining the principles of the LIFT procedure with the tissue support of a Martius graft, this approach offers a safe and effective solution for women seeking relief from this debilitating condition. As research continues to explore and refine surgical techniques, women can feel empowered knowing that innovative solutions are available to improve their quality of life.