Igwe P O, Brownson N E, Harcourt S L, Ejindu N
Colorectal and Minimal Access, General Surgery Unit, Department of Surgery, University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Rivers State, Nigeria.
Orthopedic Surgery Unit, Department of Surgery, University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Rivers State, Nigeria.
Int J Surg Case Rep. 2020;72:277-280. doi: 10.1016/j.ijscr.2020.06.002. Epub 2020 Jun 11.
Laparoscopy is a relatively new surgical approach in developing countries. Migrated foreign bodies into the body cavities could be very distressing to patients, relations and caregivers. There are paucity of migrated Steinmann pin and laparoscopic retrieval methods in literature.
An innovative approach of laparoscopic retrieval of migrated sharp foreign body (Steinmann pin).
A two-port technique was used to retrieve the pin. These ports consisted of optical supra-umbilical port (10 mm) and left iliac fossa port of 10 mm. They were aligned in the direction of sharp end of the foreign body, to aid retrieval of the Steinmann pin. This procedure was performed on a 34-year-old man who presented with migration of Steinmann pin into abdominal cavity. He had open reduction of old unreduced left posterior hip dislocation. A Steinmann pin with a diameter of 4.5 mm and length of 140 mm was passed through the greater trochanter to the acetabular roof. The protruding end of the pin ought to have been bent. Three weeks post-surgery, the pin migrated. Physical examination revealed vague tenderness over supra pubic region. A hard pointed object was palpable in the right iliac fossa. Abdominal X-ray and ultrasound were suggestive but not definite for pin location.
A sharp Steinman pin was retrieved from the abdominal cavity using laparoscopy.
Migration of Steinmann pin is unusual. Laparoscopy is an innovative approach to foreign body retrieval. This could help reduce the morbidity that may be accompanied by other modalities such as open approach.
腹腔镜检查在发展中国家是一种相对较新的手术方法。异物迁移到体腔中可能会给患者、家属和护理人员带来极大困扰。文献中关于迁移的斯氏针及腹腔镜取出方法的报道较少。
介绍一种腹腔镜取出迁移的尖锐异物（斯氏针）的创新方法。
采用双孔技术取出斯氏针。这两个孔包括脐上光学孔（10毫米）和左髂窝10毫米孔。它们与异物尖锐端的方向对齐，以协助取出斯氏针。该手术在一名34岁男性患者身上进行，该患者的斯氏针迁移至腹腔。他曾接受陈旧性左后髋关节脱位切开复位术。一根直径4.5毫米、长度140毫米的斯氏针穿过大转子至髋臼顶。针的突出端本应弯曲。术后三周，针发生迁移。体格检查发现耻骨上区域有模糊压痛。在右髂窝可触及一个硬的尖状物。腹部X线和超声检查对针的位置有提示作用但不明确。
通过腹腔镜从腹腔中取出了一根尖锐的斯氏针。
斯氏针迁移并不常见。腹腔镜检查是一种取出异物的创新方法。这有助于降低可能伴随其他方法（如开放手术）出现的发病率。
