Abstract Introduction: Rectovaginal fistula caused by Behçet's disease is extremely rare, and the clinical course is very unfavorable. We describe rectovaginal fistula of Behçet's disease with successful laparoscopic treatment, and review the literature. Case presentation: A 30-year-old woman with Behçet's disease was diagnosed with rectovaginal fistula, and treated medically after fecal diversion colostomy. However, the fistula remained, and she underwent radical surgery. Laparoscopically, after mobilization of the rectum, the fistula was removed. The rectum was transected on the anal side of the fistula, and removed after extraction through the vaginal incision. The vaginal incision was repaired by suturing, and rectal anastomosis was performed using a double-stapling technique. The omentum was fixed between the rectum and vagina, and the operation was completed. Six months after the laparoscopic surgery, no evidence of fistula recurrence has been seen on colonoscopy. Conclusion: We have reported a rare case of rectovaginal fistula of Behçet's disease treated with an altogether new surgical approach that might prove effective for refractory rectovaginal fistula.

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