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Needle lost in minimally invasive surgery: management proposal and literature review

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Abstract

The reported incidence of intraoperative retained instruments, such as needles, hangs around 0.06–0.11%. Leaving a needle inside the abdominal cavity can have significant medical and legal consequences. In addition, the retrieval can be hampered due to the limited visualization of the scope during minimally invasive surgery. Factors associated with an increased probability for NL have been described. Prevention for this situation includes: having one needle at a time inside the cavity, effective communication between all personnel in the operating room, evaluation of the strength of the suture–needle connection, avoid parking of needles intraoperatively, and a proper needle withdrawal. Notwithstanding, no agreement has been made regarding NL management. Herein, we present a literature review, and a management proposal in which through a series of systematic steps, the surgical team can efficiently locate and retrieve a lost needle such as: examination of the surgical field, trocar visualization, trocar disassembly, and revision of the suction device. Finally, intraoperative or postoperative imaging can be utilized.

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Funding

This study was not funded by any institution.

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Authors and Affiliations

  1. Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, 1441 Eastlake Avenue, Suite 7416, Los Angeles, CA, 90089-2211, USA

    Luis G. Medina, Giovannni E. Cacciamani, Nariman Ahmadi & Rene Sotelo

  2. Facultad de Medicina, Clínica Cooperativa de Colombia, Universidad Cooperativa de Colombia, Villavicencio, Colombia

    Oscar Martin

  3. Unidad de Cirugía Robótica e Invasión Mínima (UNIC), Caracas, Venezuela

    Juan C. Castro

Authors
  1. Luis G. Medina
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  2. Oscar Martin
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  3. Giovannni E. Cacciamani
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  4. Nariman Ahmadi
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  5. Juan C. Castro
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  6. Rene Sotelo
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Corresponding author

Correspondence to Luis G. Medina.

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Conflict of interest

Authors Medina L. G, Martin O, Cacciamani G. E, Ahmadi N, Castro J. C, and Sotelo R declare that they have no conflict of interest.

Ethical approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 [5]. Informed consent was obtained from all patients for being included in the study.

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Medina, L.G., Martin, O., Cacciamani, G.E. et al. Needle lost in minimally invasive surgery: management proposal and literature review. J Robotic Surg 12, 391–395 (2018). https://doi.org/10.1007/s11701-018-0802-9

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  • DOI: https://doi.org/10.1007/s11701-018-0802-9

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