Laser-assisted removal of aspirated thumbtacks by flexible bronchoscopy

Background. Aspirated thumbtacks are difficult to extract as the sharp edge of the thumbtack often is well imbedded within bronchial wall and its removal is technically demanding and may cause complications such as bronchial mucosal tear and bronchial wall perforation. These sharp metal objects are commonly removed using rigid bronchoscopy since their removal through flexible bronchoscopy is considered to be dangerous. Objectives. To describe a technique for removal of sharp aspirated metal objects employing laser through flexible bronchoscopy. Methods. We report two patients in whom a new technique for removal of sharp aspirated metal objects utilizing Nd-Yag laser flexible bronchoscopy was used. Results. Successful and uncomplicated removal of the aspirated thumbpack by flexible bronchoscopy under conscious sedation was accomplished in the two patients described. Both patients were discharged within 24 hours. Conclusions. In patients with aspirated thumbtack laser-assisted breakage of the object through flexible bronchoscopy may obviate the need for rigid bronchoscopy or thoracotomy.