Ohyama Takehiro, Shimbo Masaki, Endo Fumiyasu, Hattori Kazunori
Department of Urology St. Luke's International Hospital Tokyo Japan.
IJU Case Rep. 2021 Nov 11;5(1):49-52. doi: 10.1002/iju5.12386. eCollection 2022 Jan.
Hem-o-Lok clips are widely used in robot-assisted radical prostatectomy because of their ease of application and secure clamping. Although there have been some reports of their migration into the urinary tract, this usually occurs a few months after robot-assisted radical prostatectomy. Late-onset cases of Hem-o-Lok clip migration, that is, after more than 1 year, are rare.
We report three cases of delayed endourethral Hem-o-Lok clip migration more than 2 years after robot-assisted radical prostatectomy. The Hem-o-Lok clips were almost completely endoluminal, and were attached at one end to the vesicourethral anastomosis. We successfully removed them via transurethral surgery using a holmium laser.
This case series describes late-onset Hem-o-Lok clip migration into the bladder more than 1 year after robot-assisted radical prostatectomy. Transurethral holmium laser surgery was very effective for Hem-o-Lok clip removal. To avoid involvement of Hem-o-Lok clips in the vesicourethral anastomosis, appropriate resection at the time of bladder neck transection is important.
Hem-o-Lok夹因其应用简便且夹闭牢固，在机器人辅助根治性前列腺切除术中被广泛使用。尽管已有一些关于其迁移至尿路的报道，但这通常发生在机器人辅助根治性前列腺切除术后数月。Hem-o-Lok夹迁移的迟发病例，即术后1年以上发生的情况较为罕见。
我们报告3例机器人辅助根治性前列腺切除术后2年以上发生的迟发性尿道内Hem-o-Lok夹迁移病例。Hem-o-Lok夹几乎完全位于腔内，一端附着于膀胱尿道吻合处。我们通过经尿道钬激光手术成功将其取出。
本病例系列描述了机器人辅助根治性前列腺切除术后1年以上发生的迟发性Hem-o-Lok夹迁移至膀胱的情况。经尿道钬激光手术对取出Hem-o-Lok夹非常有效。为避免Hem-o-Lok夹累及膀胱尿道吻合处，膀胱颈横断时进行适当切除很重要。
