Tunnard Gavin J, Biyani Chandra S
Department of Urology, Pinderfields General Hospital, Wakefield, United Kingdom.
J Laparoendosc Adv Surg Tech A. 2009 Oct;19(5):649-51. doi: 10.1089/lap.2009.0145.
Delayed migration of a Hem-o-Lok device into the bladder following laparoscopic radical prostatectomy has been described a small number of times in the literature. In this article, we describe the case of a 67-year-old gentleman who had undergone a laparoscopic radical prostatectomy and returned 8 months later for follow-up investigations due to intractable urinary symptoms. A flexible cystoscopy revealed a tight bladder neck. At this stage, the patient was listed for a rigid cystoscopy and bladder neck dilatation; during the procedure, a Hem-o-Lok (Weck Surgical Instruments, Teleflex Medical, Durham, NC) was found in the bladder, having migrated from the urethrovesical anastomosis, and was successfully removed. On repeat cystoscopy 3 months later, a further Hem-o-Lok device was found eroded through the vesicourethral anastomosis and was successfully removed with the aid of a holmium laser.
腹腔镜根治性前列腺切除术后Hem-o-Lok装置延迟迁移至膀胱的情况在文献中已有少数报道。在本文中,我们描述了一名67岁男性的病例,该患者接受了腹腔镜根治性前列腺切除术,8个月后因顽固性泌尿系统症状返回进行随访检查。软性膀胱镜检查显示膀胱颈狭窄。此时,患者被安排进行硬性膀胱镜检查和膀胱颈扩张;在手术过程中,发现一个Hem-o-Lok(维克外科器械公司,泰利福医疗,北卡罗来纳州达勒姆)从尿道膀胱吻合口迁移至膀胱,并成功取出。3个月后再次进行膀胱镜检查时,发现另一个Hem-o-Lok装置通过膀胱尿道吻合口侵蚀出来,并借助钬激光成功取出。