破損・脱落した腹腔鏡手術用バイポーラ鉗子の部品の回収にX線透視とバッグが有用であった1例

抄録

　Due to the precision and small size of laparoscopic devices, if part of the device is damaged and falls off, it can be highly difficult to recover. We report a case in which a part of bipolar forceps broke and fell off, but was retrieved through the effective use of fluoroscopy and a specimen retrieval bag.

　A 42-year-old Japanese woman with bilateral ovarian tumors and multiple myoma underwent laparoscopic cystectomy and myomectomy. Postoperative abdominal X-ray revealed a foreign body in the pelvic region. Although the site of damage to the surgical device was not identified, the part was considered to have fallen off during surgery and we attempted to retrieve it by laparoscopy. In consideration of movement of the foreign body depending on the posture, fluoroscopy was performed at a low head position. In addition, by photographing from two directions, the foreign body was easily identified at the suspected site in the pelvis. Furthermore, considering the possibility of breakage and reshedding of the foreign body during retrieval, it was placed in a bag and recovered safely.

　When searching for missing parts during laparoscopic surgery, it is important to identify them by fluoroscopy in the same operating position. Recovery by bagging was considered to be effective at preventing re-shedding.