JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY
Online ISSN : 1884-5746
Print ISSN : 1884-9938
Case report
Detection of a Missing Surgical Device during Laparoscopic Gynecologic Surgery: Case report
Toshiyuki SekiKazu UedaHitoshi MatsuiKeiko NakajimaYouko NagayoshiMomoko InoueAyako KawabataChikage NaruiRyusuke KayaYasushi IidaHirokuni TakanoAikou Okamoto
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2015 Volume 30 Issue 2 Pages 450-454

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Abstract
  Misplacement and retention of a small surgical device should be avoided because it may result in complications such as infection or injury. Compared to a laparotomy, because of limited visualization during laparoscopic surgery, loss of a small surgical device is more likely and detection is more difficult.
  A 48-year-old woman underwent a total laparoscopic hysterectomy for cervical adenocarcinoma in situ. During the surgery, we used 5 mm metallic clips for bundling the tapes, which marked the ureters. When we removed the tapes and clips through a 12 mm trocar following removal of the uterus, one of metallic clips was missing. Laparoscopic exploration of the abdominal cavity, a search of the entire operating room, and exploration of the interior of the trocar failed to detect the clip.
  We then ordered abdominal X-rays while the patient was still under anesthesia; however, the item was not located. Subsequently, an X-ray of the trocar detected the clip buried deep within it. Detection of small devices are difficult during laparoscopic surgery; therefore, we should handle them carefully.
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© 2015 Japan Society of Gynecologic and Obstetric Endoscopy and Minimally Invasive Therapy
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