Introduction and hypothesis: Rectovaginal fistula repair is one of the most challenging gynecological surgical procedures. This video is intended to serve as a tutorial for surgical repair.
Methods: An 80-year-old woman who developed a traumatic suprasphincteric rectovaginal fistula was managed through layered transvaginal repair without flaps.
Results: Anatomy restoration was completed without complications.
Conclusion: The procedure described in this video was effective and safe. Vaginal route should be considered as a valid surgical approach for rectovaginal fistula repair.
Keywords: Layered primary repair; Rectovaginal fistula; Traumatic fistula; Vaginal route.