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Calculus formation and ureteral obstruction after ileal conduit construction using autosuture stapling device
G D Webster1, H H Henry, E M Tomlin
1Department of Surgery, Duke University Medical Center, Durham, North Carolina.
Urology
|December 1, 1987
Summary
A surgical staple caused ureteral obstruction after urinary diversion. To prevent this complication, surgeons should remove staple lines from the ileal conduit loop and use absorbable material for closure.
Area of Science:
- Urology
- Surgical Innovation
- Medical Device Complications
Background:
- Urinary diversion procedures, such as ileal conduit formation, are common for managing bladder dysfunction.
- The use of automated stapling devices has become prevalent in gastrointestinal and urological surgery.
- Potential complications associated with surgical staples, including calculus formation, require careful consideration.
Observation:
- A rare case of ureteral obstruction was identified in a patient post-urinary diversion surgery.
- The obstruction was caused by a surgical staple that had become encrusted with urinary calculus.
- The patient had undergone construction of an ileal conduit using an autosuture stapling device.
Findings:
- Surgical staples left within the ileal conduit lumen can serve as a nidus for calculus formation.
- Calculus-encrusted staples can lead to significant complications, including ureteral obstruction and potential renal damage.
- The staple suture line from the autosuture device was implicated in the observed complication.
Implications:
- Recommendations for surgical technique modifications are crucial to prevent staple-related complications in ileal conduit surgery.
- Excision of the staple suture line from both ends of the isolated ileal loop is advised.
- Closing the butt end of the ileal conduit with absorbable material may reduce the risk of foreign body reactions and subsequent calculus formation.