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Case Report
Intraoperative breakage of a laparoscopic needle holder confirmed by postoperative abdominal X-ray: A case report and literature review
1 MD, Department of Obstetrics and Gynecology, Kaizuka City Hospital, Osaka, Japan
2 MD, Department of Gynecology, Osaka International Cancer Institute, Osaka, Japan
3 MD, PhD, Department of Obstetrics and Gynecology, Kaizuka City Hospital, Osaka, Japan
Address correspondence to:
Yoshikazu Nagase
MD, Department of Obstetrics and Gynecology, Kaizuka City Hospital, 3-10-20 Hori, Kaizuka, Osaka 597-0015,
Japan
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Article ID: 100137Z08RH2023
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How to cite this article
Hirose R, Nagase Y, Kurahashi H, Tanaka A, Masuda K, Yokoi T. Intraoperative breakage of a laparoscopic needle holder confirmed by postoperative abdominal X-ray: A case report and literature review. J Case Rep Images Obstet Gynecol 2023;9(1):17–20.ABSTRACT
Introduction: Intraperitoneal retention of surgical instrument fragments may lead to severe complications. Therefore, such foreign bodies must be detected before surgery completion. We present a case with intraoperative breakage of a laparoscopic needle holder confirmed by a routine postoperative abdominal X-ray and review the literature regarding intraoperative laparoscopic instrument breakage.
Case Report: A 58-year-old woman with stage IB1 cervical adenocarcinoma underwent a laparoscopic radical hysterectomy. Surgery was completed without major complications; however, an abdominal X-ray as a routine postoperative examination revealed a radiopaque shadow of approximately 3 mm corresponding to a broken part of the tissue-pad of the laparoscopic needle holder tip. It was successfully removed using laparoscopy with fluoroscopic guidance without further complications. According to the literature review, most of the instrument breakage were noticed during surgery as they were either obvious or impaired function. In our case, since the detached foreign body was extremely small and did not significantly affect needle holder function, it remained unnoticed until the postoperative X-ray was taken.
Conclusion: Postoperative abdominal X-rays identify instrumental fragments infrequently; however, they may help detect intraperitoneal retention of foreign bodies and avoid serious complications following laparoscopic surgery.
Keywords: Breakage, Foreign body, Laparoscopic surgery
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Acknowledgments
The authors would like to thank Enago (www.enago.jp) for the English language review.
Author ContributionsRikuto Hirose - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Yoshikazu Nagase - Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Hiroki Kurahashi - Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Asuka Tanaka - Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Kumi Masuda - Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Takeshi Yokoi - Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2023 Rikuto Hirose et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
