Intraneobladder Hem-o-Lok Migration with Stone Formation after Orthotopic Neobladder Cystectomy

Introduction. Laparoscopic and robot-assisted laparoscopic surgery are widely performed in urology field, so Hem-o-Lok clips are thus extensively used in the laparoscopic procedures. We describe the first case of Hem-o-Lok clip which migrated into the neobladder with calculus formation 26 months aft...

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Main Authors: Zeng Shu-xiong, Zhang Zhen-sheng, Yu Xiao-wen, Li Hui-zhen, Lu Xin, Sun Ying-hao, Xu Chuan-liang
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:Case Reports in Urology
Online Access:http://dx.doi.org/10.1155/2014/872989
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author Zeng Shu-xiong
Zhang Zhen-sheng
Yu Xiao-wen
Li Hui-zhen
Lu Xin
Sun Ying-hao
Xu Chuan-liang
author_facet Zeng Shu-xiong
Zhang Zhen-sheng
Yu Xiao-wen
Li Hui-zhen
Lu Xin
Sun Ying-hao
Xu Chuan-liang
author_sort Zeng Shu-xiong
collection DOAJ
description Introduction. Laparoscopic and robot-assisted laparoscopic surgery are widely performed in urology field, so Hem-o-Lok clips are thus extensively used in the laparoscopic procedures. We describe the first case of Hem-o-Lok clip which migrated into the neobladder with calculus formation 26 months after laparoscopic orthotopic neobladder cystectomy, which causes symptoms of gross hematuria and frequent urination. Case Presentation. A 57-year-old man with T2a muscle invasive bladder cancer underwent laparoscopic orthotopic sigmoid neobladder reconstruction after cystectomy which was complicated by intestinal anastomosis leak and peritoneal abscess requiring transverse colostomy and drainage 15 days postoperatively. Twenty-six months after cystectomy, he complained of gross hematuria and frequent urination. Computerized tomography and plain pelvic X-ray revealed a stone measuring approximately 2.8 cm in diameter in the neobladder. During cystoscopy, a closed whitish Hem-o-Lok clip was seen in the center of the calculi. No anastomotic leak or neoplasm was found during cystoscopy. Conclusion. Hem-o-Lok clip migration into the bladder after laparoscopic orthotopic neobladder cystectomy is a rare complication; the first reported case in the literature. To prevent Hem-o-Lok clip migration, it is recommended to avoid extensive use of Hem-o-Lok clip close to anastomosis site, and any loose Hem-o-Lok clip should be retrieved before closure.
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institution Kabale University
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spelling doaj-art-2a61c9f5ff17426ca3c636708aed36d92025-02-03T01:23:49ZengWileyCase Reports in Urology2090-696X2090-69782014-01-01201410.1155/2014/872989872989Intraneobladder Hem-o-Lok Migration with Stone Formation after Orthotopic Neobladder CystectomyZeng Shu-xiong0Zhang Zhen-sheng1Yu Xiao-wen2Li Hui-zhen3Lu Xin4Sun Ying-hao5Xu Chuan-liang6Department of Urology, Changhai Hospital, Second Military Medical University, Changhai Road No. 168, Yangpu District, Shanghai 200433, ChinaDepartment of Urology, Changhai Hospital, Second Military Medical University, Changhai Road No. 168, Yangpu District, Shanghai 200433, ChinaDepartment of Geriatrics, Changhai Hospital, Second Military Medical University, Shanghai 200433, ChinaDepartment of Urology, Changhai Hospital, Second Military Medical University, Changhai Road No. 168, Yangpu District, Shanghai 200433, ChinaDepartment of Urology, Changhai Hospital, Second Military Medical University, Changhai Road No. 168, Yangpu District, Shanghai 200433, ChinaDepartment of Urology, Changhai Hospital, Second Military Medical University, Changhai Road No. 168, Yangpu District, Shanghai 200433, ChinaDepartment of Urology, Changhai Hospital, Second Military Medical University, Changhai Road No. 168, Yangpu District, Shanghai 200433, ChinaIntroduction. Laparoscopic and robot-assisted laparoscopic surgery are widely performed in urology field, so Hem-o-Lok clips are thus extensively used in the laparoscopic procedures. We describe the first case of Hem-o-Lok clip which migrated into the neobladder with calculus formation 26 months after laparoscopic orthotopic neobladder cystectomy, which causes symptoms of gross hematuria and frequent urination. Case Presentation. A 57-year-old man with T2a muscle invasive bladder cancer underwent laparoscopic orthotopic sigmoid neobladder reconstruction after cystectomy which was complicated by intestinal anastomosis leak and peritoneal abscess requiring transverse colostomy and drainage 15 days postoperatively. Twenty-six months after cystectomy, he complained of gross hematuria and frequent urination. Computerized tomography and plain pelvic X-ray revealed a stone measuring approximately 2.8 cm in diameter in the neobladder. During cystoscopy, a closed whitish Hem-o-Lok clip was seen in the center of the calculi. No anastomotic leak or neoplasm was found during cystoscopy. Conclusion. Hem-o-Lok clip migration into the bladder after laparoscopic orthotopic neobladder cystectomy is a rare complication; the first reported case in the literature. To prevent Hem-o-Lok clip migration, it is recommended to avoid extensive use of Hem-o-Lok clip close to anastomosis site, and any loose Hem-o-Lok clip should be retrieved before closure.http://dx.doi.org/10.1155/2014/872989
spellingShingle Zeng Shu-xiong
Zhang Zhen-sheng
Yu Xiao-wen
Li Hui-zhen
Lu Xin
Sun Ying-hao
Xu Chuan-liang
Intraneobladder Hem-o-Lok Migration with Stone Formation after Orthotopic Neobladder Cystectomy
Case Reports in Urology
title Intraneobladder Hem-o-Lok Migration with Stone Formation after Orthotopic Neobladder Cystectomy
title_full Intraneobladder Hem-o-Lok Migration with Stone Formation after Orthotopic Neobladder Cystectomy
title_fullStr Intraneobladder Hem-o-Lok Migration with Stone Formation after Orthotopic Neobladder Cystectomy
title_full_unstemmed Intraneobladder Hem-o-Lok Migration with Stone Formation after Orthotopic Neobladder Cystectomy
title_short Intraneobladder Hem-o-Lok Migration with Stone Formation after Orthotopic Neobladder Cystectomy
title_sort intraneobladder hem o lok migration with stone formation after orthotopic neobladder cystectomy
url http://dx.doi.org/10.1155/2014/872989
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