Sun J, Zhao LW, Wang XL, Huang JG, Fan Y. Migration of a Hem-o-Lok clip to the renal pelvis after laparoscopic partial nephrectomy: A case report. World J Clin Cases 2022; 10(10): 3188-3193 [PMID: 35611134 DOI: 10.12998/wjcc.v10.i10.3188]
Corresponding Author of This Article
Yi Fan, MD, Chief Physician, Professor, Department of Urology, The Affiliated Xiaoshan Hospital, Hangzhou Normal University, No. 728 North Yucai Road, Xiaoshan District, Hangzhou 311202, Zhejiang Province, China. doctorlevi@163.com
Research Domain of This Article
Urology & Nephrology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Apr 6, 2022; 10(10): 3188-3193 Published online Apr 6, 2022. doi: 10.12998/wjcc.v10.i10.3188
Migration of a Hem-o-Lok clip to the renal pelvis after laparoscopic partial nephrectomy: A case report
Ji Sun, Li-Wei Zhao, Xu-Liang Wang, Jia-Guo Huang, Yi Fan
Ji Sun, Li-Wei Zhao, Jia-Guo Huang, Yi Fan, Department of Urology, The Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou 311202, Zhejiang Province, China
Li-Wei Zhao, Yi Fan, Department of Urology, School of Medicine, Hangzhou Normal University, Hangzhou 311121, Zhejiang Province, China
Xu-Liang Wang, Department of Urology, The Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
Author contributions: Sun J and Zhao LW performed the case report and wrote the manuscript; Wang XL and Huang JG reviewed the literature; Fan Y was the patient’s surgeons, supervised the work, and edited the manuscript; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient and patient’s husband for publication of this report and any accompanying images obtained at the time of the investigations, but not at the time of writing the patient case report.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yi Fan, MD, Chief Physician, Professor, Department of Urology, The Affiliated Xiaoshan Hospital, Hangzhou Normal University, No. 728 North Yucai Road, Xiaoshan District, Hangzhou 311202, Zhejiang Province, China. doctorlevi@163.com
Received: July 17, 2021 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
Abstract
BACKGROUND
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.
CASE SUMMARY
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.
CONCLUSION
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.
