病例報告：術中遺失組織血管辨識圈的困境-意外被腔鏡抽吸裝置吸入

黃君平、曹智惟、蒙恩、丁慧恭

國防醫學院三軍總醫院 外科部 泌尿外科

Case Report: The Dilemma of the Disappearing Vessel Loop – Unnoticed Sudden Removal by Laparoscopic Suction Instrument

Chun-Ping Huang, Chih-Wei Tsao, En Meng, Hui-Kung Ting

Division of Urology, Department of Surgery, Tri-Service General Hospital, National

Defense Medical Center, Taipei 114024, Taiwan, ROC

Introduction: The vessel loop is commonly used in laparoscopic surgery to mark and retract vessels. It is long in shape and radiopaque, but it may still go missing during surgery and be difficult to retrieve. A common cause is that it is left in the body cavity. We report a scarce case where a vessel loop was accidentally suctioned into a laparoscopic suction device.

Case Presentation: A 54-year-old male underwent laparoscopic partial nephrectomy of the left kidney. While attempting to isolate and mark the renal artery during the operation, the vessel loop suddenly went missing. Although an immediate endoscopic search was conducted, it was unsuccessful. After completing the partial nephrectomy, the search continued using fluoroscopy, and even a mini-laparotomy was performed to eviscerate the intestines, but the vessel loop could not be found. It was eventually discovered inside the suction tube connected to the laparoscopic suction device.

Conclusions: Laparoscopic suction devices can inadvertently suction small items like needles or even vessel loops. When using a vessel loop in laparoscopic surgery, it is recommended to fold it into a circular shape by using a Hem-O-Loc clip to increase its cross-sectional area, thereby preventing it from being suctioned. Additionally, immediate playback of intraoperative video footage can aid in locating missing foreign objects.