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Paravesical gossypiboma following inguinal herniorrhaphy: Laparoscopic retrieval.

Huang CC, Huang CJ, Hsieh JS - J Minim Access Surg (2015 Jul-Sep)

Bottom Line: Laboratory and imaging studies excluded any significant lesion in the urological organs.Abdominal CT and clinical suspicion are helpful for diagnosis.Laparoscopy may be used to confirm the diagnosis and to remove the retained surgical gauze, and considered as an alternative therapy for some selected patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Pingtung Hospital, Ministry of Health and Welfare, Pingtung, Taiwan.

ABSTRACT
Retained surgical sponge (gossypiboma) following an inguinal herniorrhaphy is a rare condition and may cause medicolegal problems. Differential diagnosis for the lesion should be made meticulously. We report a case of a 45-year-old man who had a herniorrhaphy about 8 years previously. He presented one episode of painless gross hematuria. Laboratory and imaging studies excluded any significant lesion in the urological organs. Abdominal CT scan demonstrated a heterogeneous neoplasm of 4 cm in size in the left paravesical area that was retrieved laparoscopically. Abdominal CT and clinical suspicion are helpful for diagnosis. Laparoscopy may be used to confirm the diagnosis and to remove the retained surgical gauze, and considered as an alternative therapy for some selected patients.

No MeSH data available.


Related in: MedlinePlus

Laparoscopy showing a paravesical tumor lateral to the left side of the urinary bladder. (a) Following sharp dissection on the tumor capsule, yellowish seropurulent fluid being drained outside the tumor. (b) A surgical gauze being removed from the tumor. (c and d)
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Figure 2: Laparoscopy showing a paravesical tumor lateral to the left side of the urinary bladder. (a) Following sharp dissection on the tumor capsule, yellowish seropurulent fluid being drained outside the tumor. (b) A surgical gauze being removed from the tumor. (c and d)

Mentions: Under general anesthesia, the patient was operated on via laparoscopic approach in supine position. After creation of a pneumoperitoneum, a 10-mm periumbilical port and two 5-mm ports in the left and right lower quadrants were made. On inspecting the pelvic cavity, a golf ball-sized tumor arising from the preperitoneal space lateral to the left side of the urinary bladder was found [Figure 2a]. Following sharp dissection on the tumor capsule, a piece of surgical gauze with odorless seropurulent fluid was disclosed [Figure 2b]. The gauze was removed by expanding the wound in the peritoneal part of the mass [Figures 2c and d]. After evacuation of the cavity of the mass, a rubber catheter was placed as a drain. The patient got an uneventful recovery and was discharged on the third postoperative day.


Paravesical gossypiboma following inguinal herniorrhaphy: Laparoscopic retrieval.

Huang CC, Huang CJ, Hsieh JS - J Minim Access Surg (2015 Jul-Sep)

Laparoscopy showing a paravesical tumor lateral to the left side of the urinary bladder. (a) Following sharp dissection on the tumor capsule, yellowish seropurulent fluid being drained outside the tumor. (b) A surgical gauze being removed from the tumor. (c and d)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4499932&req=5

Figure 2: Laparoscopy showing a paravesical tumor lateral to the left side of the urinary bladder. (a) Following sharp dissection on the tumor capsule, yellowish seropurulent fluid being drained outside the tumor. (b) A surgical gauze being removed from the tumor. (c and d)
Mentions: Under general anesthesia, the patient was operated on via laparoscopic approach in supine position. After creation of a pneumoperitoneum, a 10-mm periumbilical port and two 5-mm ports in the left and right lower quadrants were made. On inspecting the pelvic cavity, a golf ball-sized tumor arising from the preperitoneal space lateral to the left side of the urinary bladder was found [Figure 2a]. Following sharp dissection on the tumor capsule, a piece of surgical gauze with odorless seropurulent fluid was disclosed [Figure 2b]. The gauze was removed by expanding the wound in the peritoneal part of the mass [Figures 2c and d]. After evacuation of the cavity of the mass, a rubber catheter was placed as a drain. The patient got an uneventful recovery and was discharged on the third postoperative day.

Bottom Line: Laboratory and imaging studies excluded any significant lesion in the urological organs.Abdominal CT and clinical suspicion are helpful for diagnosis.Laparoscopy may be used to confirm the diagnosis and to remove the retained surgical gauze, and considered as an alternative therapy for some selected patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Pingtung Hospital, Ministry of Health and Welfare, Pingtung, Taiwan.

ABSTRACT
Retained surgical sponge (gossypiboma) following an inguinal herniorrhaphy is a rare condition and may cause medicolegal problems. Differential diagnosis for the lesion should be made meticulously. We report a case of a 45-year-old man who had a herniorrhaphy about 8 years previously. He presented one episode of painless gross hematuria. Laboratory and imaging studies excluded any significant lesion in the urological organs. Abdominal CT scan demonstrated a heterogeneous neoplasm of 4 cm in size in the left paravesical area that was retrieved laparoscopically. Abdominal CT and clinical suspicion are helpful for diagnosis. Laparoscopy may be used to confirm the diagnosis and to remove the retained surgical gauze, and considered as an alternative therapy for some selected patients.

No MeSH data available.


Related in: MedlinePlus