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Intraoperative Dislodgment and Retrieval of Broken Parts of Laparoscopic Instruments: Arduous Exercise and Lessons
Kusum Lata1, Akshita Panwar2, Isha Kriplani1
1Department of Obstetrics & Gynecology, All India Institute of Medical Sciences, Room no 3076, Third floor, New Delhi, India.
Background:
Dislodgement and breakage of instruments in laparoscopy is a rare event which not only surmounts the anxiety of the team, but also imposes an exceedingly onerous situation for the patient. Frequently a broken fragment of an instrument is confined to an area remote from the primary operative site and gets entrapped in the bowel loops or in the omentum.
Method:
We present the intraoperative loss of the distal tip of three 5-mm laparoscopy instruments (monopolar L-hook, myoma screw and tenaculum) in the abdominal cavity during endoscopy.
Result:
Various retrieval methods for laparoscopy instruments have been described.
Conclusion:
The distal working tips of laparoscopic instruments have delicate functioning and tend to fall off or break during usage. Maintenance of instruments used in endoscopy requires special care and should be done as outlined by the manufacturer. Reporting of such incidents should be encouraged and published despite the discomposure accompanying it as it aids in better understanding and learning to handle these situations.
