Endourologic management of retained surgical drains and nephrostomy tubes

A retained surgical drain or nephrostomy tube is a troublesome predicament that often has necessitated open surgical extraction. To assess the efficacy of endoscopic techniques in the management of this problem, several types of drains and tubes were placed intraperitoneally in a female pig and left for 3 weeks. Flat drains could be removed by traction. Jackson-Pratt drains could be removed by clearing the lumen of amorphous material with a guidewire and releasing the external adhesions with a 9.5Fr rigid ureteroscope passed beside the tube. The retained re-entry nephrostomy tubes could be removed under fluoroscopic control by using stone-grasping forceps and electrocautery inside the tube to incise the tissue holding the Malecot flanges. This latter method also was successful in a patient who had received intracavitary BCG after percutaneous tumor resection. Endourologic techniques can reduce the number of open operations that need to be performed to remove retained drains and tubes.