Fracture of a Probe Tip of the Ultrasonic Laparoscopic Coagurating Shears during Laparoscopic Uterine Fibroid Enucleation in which Fallen Debris was Recovered—A Case Report—

Abstract

Ultrasonic laparoscopic coagulating shears (LCS) are surgical instruments that can perform coagulation and incision at the same time by ultrasonic vibration and are often used in laparoscopic surgery. Since a large force is applied to the tip of the probe, the probe can break depending on the usage conditions. A 43-year-old woman underwent laparoscopic uterine myomectomy due to uterine fibroids. LCS became an error mode at the time of making a longitudinal incision in the muscularis layer of the posterior wall of the uterus and became unusable. Fracture of the probe tip was confirmed. Although the part of the probe was searched in the surgical field and the extracorporeal area, it could not be found. It was eventually found by using an intraoperative X-ray and could be removed outside the body. Postoperative investigation pointed out a small damage that coincided with the fractured part. It might be the cause of the fracture. We present some precautions for using the LCS and those for collecting the fallen debris, with a review of the literature.