SRM Prime Hospital Performs First-of-Its-Kind Endoscopic Repair Using Bovine Pericardial Patch to Stop Neovaginal Stool Leakage
Chennai, November 25, 2025: In a first for Tamil Nadu, SRM Prime Hospital has successfully closed a recto-neovaginal fistula in a 22-year-old transgender woman using a bovine pericardial patch, avoiding the need for major open-abdominal surgery. The patient, from a poor economic background, had developed the fistula — an abnormal connection between the rectum and the neovagina — after undergoing gender-affirming surgery at another hospital, leading to the passage of flatus and faecal matter through the neovagina.
The minimally invasive, day-care endoscopic procedure was performed by Dr. Arulprakash S., Clinical Lead and Senior Consultant, and Dr. Tarun J. George, Senior Consultant, Medical Gastroenterology and Hepatology, under the guidance of Dr. C. Paul Dilip Kumar, Director–Medical Services, SRM Prime Hospital.
According to Dr. Arulprakash, such fistulas occur in only about 1% of gender-affirming surgeries and are rarely encountered. A previous attempt elsewhere to close the fistula using an endoscopic clip provided only temporary relief. “Open abdominal surgery was being considered as the only option. Instead, we used a novel bovine pericardial patch to support and close the tract — the first such procedure in the state,” he said. The patch served as a biological scaffold to bridge tissues, and the complex closure required two endoscopists working simultaneously, a capability available in only a few centres.
Dr. Tarun J. George explained that imaging was first performed to map the fistula, followed by argon plasma coagulation to prepare the tissue. The team then placed the bovine pericardial patch within the tract and secured it with a 14 mm over-the-scope clip. “This minimally invasive approach helped the patient avoid a major operation, long hospital stay, and higher costs. She was discharged the same day and needs only a short period of rest and medication,” he said.
The patient is recovering well and is satisfied with the outcome.
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