Published online Apr 6, 2022. doi: 10.12998/wjcc.v10.i10.3188
Peer-review started: July 17, 2021
First decision: October 16, 2021
Revised: October 29, 2021
Accepted: February 22, 2022
Article in press: February 22, 2022
Published online: April 6, 2022
Processing time: 254 Days and 17.7 Hours
Hem-o-Lok clip (HOLC) has been widely used in laparoscopic surgery due to its ease of application and secure clamping, though the rare complications associated with this technique should not be ignored. The rare complications of laparoscopic partial nephrectomy consist of the clip migrating into the renal pelvis and acting as a nidus for stone formation.
The case described here involved a 63-year-old woman who was found with stones in the right kidney and upper ureter during a recent reexamination following laparoscopic partial nephrectomy. We performed percutaneous nephrolithotomy for her, but during the operation, it was found that the center of the stone within the kidney was a HOLC, which was removed with forceps. For this reason, we speculate that the HOLC, which was employed to halt tumor wound bleeding, spontaneously drifted into the renal pelvis and formed kidney stones, with the clip being initially misdiagnosed as a kidney stone.
By reviewing related case reports, we conclude that in order to prevent complications related to HOLC, loose clips should be actively searched for and retrieved from the wound during urinary tract surgery, while the deployment of clips in close proximity of anastomotic stoma of collecting systems should be avoided.
Core Tip: The present case involved a patient who was found to have a spontaneously drifted Hem-o-Lok into the renal pelvis and formed stones after laparoscopic partial nephrectomy. We conclude that in order to prevent complications related to Hem-o-Lok, loose clips should be actively sought and retrieved from the wound during urinary system surgery, while the deployment of clips in close proximity to the anastomotic stoma of collecting systems should be avoided.