IPEG 2021 - Needle Loss in Minimal Invasive Surgery is a Real Challenge : Innovative Technique for Retrieval

This is Mohammed Elirandi from pediatric surgery at Sidra Medicine in Qatar. It is a great pleasure to participate in the virtual IPIC 2021 annual meeting. First of all, I have nothing to disclose. As we know, the minimally invasive pediatric surgical technique is increasingly accepted worldwide. And the goal is to perform operations through very small incision compared by traditional surgery with equal or superior outcomes and less impact on a child's body and organs. However, there are some challenges that may encountered during minimal invasive surgery. So we would like to share with you one of those challenges we had an innovative technique that was used to solve the problem with no harm. This is a case of lost needle during a laparoscopic robotic assisted lift by yelloplasty in a seven year old child. In this video, the use of a magnetic retrieval catheter used for removal of stents is illustrated. While doing the bilvreri junction anastomosis, the small needle of PDS6O was lost. Slow motion of the video demonstrates that the needle detached from the needle driver during knotting maneuver and that was not noticed by the operating surgeon. Extensive search along the abdomen of the needle was performed but was not successful. The robot was undocked to allow free movement of the camera for an extensive search along all the abdominal quadrants. A flexible magnetic retrieval device was introduced through one of the ports and started to scan the abdominal cavity. The lost needle was detected at the time it attached strongly to the magnetic retrieval device during scanning the right upper quadrant area. The attached lost needle to magnetic retrieval device was taken out safely. Here is an extracorboreal demonstration of the magnetic retrieval device. The video demonstrated that the same magnetic tip soft probe used for removal of magnetic catheters was effective to resolve a complication occurred during laparoscopic surgery. The same allowed the surgical team to solve the problem even with no use of fluoroscopy in a relatively short time.