Computed Tomography Appearance of the Lapra-Ty® and Weck Hem-O-Lok Clips in Patients Who Recently Underwent Laparoscopic Urologic Surgery

Abstract

The nonmetal suture securing Lapra-Ty clip (LTC) and vessel ligating Weck hem-o-lock clip (WKHL) are useful tools for the laparoscopic surgeon. We report the postoperative computed tomography (CT) scan appearance of these clips. The CT imaging of patients who underwent urologic surgery demonstrate the WKHL and LTC to be radiopaque. Urologists and radiologists should be aware of the radiographic appearance of the LTC and WKHL given the ease with which they could be confused with urinary lithiasis when applied near the urinary system.

Computed Tomography Appearance of Hem-O-Lok Clips in Patients Who Have Undergone Laparoscopic Nephrectomy or Nephroureterectomy

“…Differences between the radiographic methods used at each institution might have caused the discrepancies between the findings of previous reports. 5 In this study, we found that Hem-o-lok clips were radiopaque on CT scans of patients who had undergone LRN or LRU.…”

“…2,5,6 These reports could lead to problems when radiopaque objects, such as Hem-o-lok clips, stones, or foreign bodies, are recognized near to the renal hilum on postoperative CT scans of patients who have undergone LRN or LRU. In particular, when a patient suffers postoperative flank or abdominal pain, radiopaque objects detected on postoperative CT scans might be thought to be foreign bodies related to surgery, such as part of a drainage tube.…”

“…2 Although multiple publications have attested to the safety and feasibility of using Hem-o-lok clips for laparoscopic nephrectomy, 2–4 there are few reports about the radiographic appearance of the clips, and the few reports that do exist have produced differing results. 2,5,6 We should be aware of the computed tomography (CT) appearance of Hem-o-lok clips when following up patients who have undergone LRN or laparoscopic radical nephroureterectomy (LRU). Herein, we investigate the CT appearance of Hem-o-lok clips in patients who had undergone LRN and LRU in retrospective and ex vivo studies.…”

Distal ureteral stone formation over migrated Hem-o-lok clip after robot-assisted partial nephrectomy

“…Another controversial issue is the detection of Hem-o-lok clips that have migrated into the collecting system. Variable reports about their CT-visibility exist [18,19]. Matsushita et al have shown that the density of hem-o-lok clip was 223 HU, consistent with its ex-vivo CT-based attenuation measurement [20].…”