機械手臂根除性攝護腺切除手術後發生血管夾移行至膀胱內：病例報告
葉韶豪、侯鎮邦
林口長庚紀念醫院 外科部 泌尿外科
Intravesical Hem-o-Lok Clips Migration After Robot Assisted Radical Prostatectomy – A Case Report
Shao-Hao Yeh, Chen-Pang Hou
Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou
Abstract:
Hem-o-Lok clips are commonly used for vascular control during robot assisted radical prostatectomy (RARP) as they provide a fast and secure method of non-thermal hemostasis in areas where suture ligation is difficult. Here we present a rare case with migration of Hem-o-Lok clips into the bladder after RARP.
The patient was a 62-year-old male who received RARP in Dec 2017 for localized prostate cancer (PSA: 10.2, Gleason's score 3 + 3, T3bN0M0). Post-operative condition was stable. About one year after surgery, the patient presented with intermittent gross hematuria and dysuria. Pelvic MRI showed no evidence of local recurrence, but focal bladder wall thickening with T2-hypointense nodules, suspicious bladder stone or granulation tissue. Cystoscopy revealed 3 Hem-o-Lok clips adhered to left lateral wall of bladder coating with stones, which were disintegrated, and then Hem-o-Lok clips were totally removed using cystoscopy forceps. Post-operative period was uneventful, and patient was discharged one the same day. On follow-up, intermittent gross hematuria and dysuria were subsided.