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Updated: Aug 15, 2025
Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
Unexpected discovery of surgical gauze during a robotic radical prostatectomy identified as a capturing lymph node on
Giovanni Battista Di Pierro1, Bruno Bucca1, Alessandro Sciarra1
1Department "Materno Infantile e Scienze Urologiche", University Sapienza, Policlinico Umberto I, Rome, Italy.
Abstract:
Multiparametric magnetic resonance, plays a crucial role in several steps of the management of prostate cancer. Various factors could alter the interpretation and reduce the accuracy of MR. Among these the group of the retained surgical items, can produce serious implications for the health of patient, as well as medical-legal consequences. Here we report the case of a patient, with a prostate tumor, who performed a mp-MRI of the prostate, where it was reported as collateral finding, compatible thesis with lymphadenopathy. During robotic assisted radical prostatectomy, was found a gauze, which persisted asymptomatic, retained after a previous right inguinal hernioplasty.
Insights
Retained surgical gauze after prior surgery can mimic lymphadenopathy on multiparametric MRI (mp-MRI) of the prostate. This case highlights the importance of considering surgical history to avoid misinterpreting imaging findings in prostate cancer patients.
Area of Science:
- Radiology
- Oncology
- Surgical Pathology
Background:
- Multiparametric magnetic resonance imaging (mp-MRI) is vital for prostate cancer management.
- Accurate interpretation of mp-MRI can be challenged by various factors, including retained surgical items.
- Retained surgical items pose risks to patient health and can lead to medical-legal issues.
Observation:
- A patient with prostate cancer underwent mp-MRI, which incidentally revealed findings suggestive of lymphadenopathy.
- During robotic-assisted radical prostatectomy, a retained surgical gauze was discovered.
- The gauze was a remnant from a previous right inguinal hernioplasty and had remained asymptomatic.
Findings:
- The retained surgical gauze was misinterpreted as lymphadenopathy on prostate mp-MRI.
- This imaging finding was a collateral finding during the prostate cancer workup.
- The gauze was asymptomatic and discovered intraoperatively.
Implications:
- Retained surgical items can lead to diagnostic errors in prostate cancer imaging.
- Thorough patient history, including prior surgeries, is crucial for accurate mp-MRI interpretation.
- Awareness of retained surgical items can prevent unnecessary patient anxiety and potential complications.
