Reflux of a Staple after Kock Pouch Urinary Diversion: A Nidus for Renal Stone Formation

Gronau, E.; Pannek, J.

doi:10.1089/0892779041271689

Cited by 10 publications

(3 citation statements)

References 4 publications

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“…Massoud[ 16 ] also reported that a metal surgical clip was displaced into the ureter after open partial nephrectomy (OPN), all of which was passed spontaneously. Furthermore, in the urologic literature, it has been reported that surgical clips, and even absorbable gastrointestinal staples, can act as a nidus for stone formation when in contact with urine[ 17 ]. Msezane et al [ 18 ] reviewed differing sealants and laparoscopic instruments that can be used to stop bleeding of the renal parenchyma within LPN and concluded that there is no gold-standard single agent or combination of products that can be applied to all cases.…”

Section: Discussionmentioning

confidence: 99%

Migration of a Hem-o-Lok clip to the renal pelvis after laparoscopic partial nephrectomy: A case report

Sun¹,

Zhao²,

Wang³

et al. 2022

WJCC

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BACKGROUND Hem-o-Lok clip (HOLC) has been widely used in laparoscopic surgery due to its ease of application and secure clamping, though the rare complications associated with this technique should not be ignored. The rare complications of laparoscopic partial nephrectomy consist of the clip migrating into the renal pelvis and acting as a nidus for stone formation. CASE SUMMARY The case described here involved a 63-year-old woman who was found with stones in the right kidney and upper ureter during a recent reexamination following laparoscopic partial nephrectomy. We performed percutaneous nephrolithotomy for her, but during the operation, it was found that the center of the stone within the kidney was a HOLC, which was removed with forceps. For this reason, we speculate that the HOLC, which was employed to halt tumor wound bleeding, spontaneously drifted into the renal pelvis and formed kidney stones, with the clip being initially misdiagnosed as a kidney stone. CONCLUSION By reviewing related case reports, we conclude that in order to prevent complications related to HOLC, loose clips should be actively searched for and retrieved from the wound during urinary tract surgery, while the deployment of clips in close proximity of anastomotic stoma of collecting systems should be avoided.

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Section: Discussionmentioning

confidence: 99%

Migration of a Hem-o-Lok clip to the renal pelvis after laparoscopic partial nephrectomy: A case report

Sun¹,

Zhao²,

Wang³

et al. 2022

WJCC

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“…However, a few case reports have described intravesical migration of Weck Hem-o-lok clips leading to stone formation after radical prostatectomy [5, 6]. Other reports have shown that staples used during cystectomy and urinary diversions may also cause stone formation when they are in direct contact with urine [7]. Furthermore, in an investigation of various suture materials in the bladder wall of rats, Kosan et al found that the duration of contact between foreign body and urine was the greatest predictor of stone formation [8].…”

Section: Discussionmentioning

confidence: 99%

Stone Formation from Nonabsorbable Clip Migration into the Collecting System after Robot-Assisted Partial Nephrectomy

Lee

Reilly

Moore

et al. 2014

Case Reports in Urology

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We describe a case in which a Weck Hem-o-lok clip (Teleflex, Research Triangle Park, USA) migrated into the collecting system and acted as a nidus for stone formation in a patient after robot-assisted partial nephrectomy. The patient presented 2 years postoperatively with left-sided renal colic. Abdominal computed tomography scan showed a 10 millimeter renal calculus in the left middle pole. After using laser lithotripsy to fragment the overlying renal stone, a Weck Hem-o-lok clip was found to be embedded in the collecting system. A laser fiber through a flexible ureteroscope was used to successfully dislodge the clip from the renal parenchyma, and a stone basket was used to extract the clip.

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“…Metabolic complications may occur in patients with urinary intestinal diversion as a result of the resorption of urinary solutes across the bowel segment, including serum electrolyte abnormalities, bony demineralization and calculus formation [1,2,3,4,5,6,7,8,9,10]. …”

Section: Introductionmentioning

confidence: 99%

Use of Nonabsorbable Staples for Urinary Diversion: A Step in the Wrong Direction

Suriano

Daneshmand²,

Buscarini

2012

Urol Int

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Background: The use of bowel segments incorporated into the urinary tract is well established in urological surgery. Objective: To describe and compare the use of absorbable and nonabsorbable staples for creation of a urine reservoir after radical cystectomy. Materials and Methods: This review is based on a systematic Medline search assessing the period 1950-2010. Results: Use of the autosuture stapling device for the construction of the urinary diversion significantly reduces operating time. Johnson and Fuerst reported its use for the first time to construct a ureteroileocutaneous urinary diversion in 1973. However, many studies demonstrated that exposed metal staples represent a nidus for stone formation when they are in direct contact with urine, particularly in urinary diversions such as Kock pouch and ileal conduit. Stone formation has been attributed in part to the use of nonabsorbable artificial materials, such as metal staples and Marlex mesh, strictures of the pouch and accumulation of mucus. The treatment options for pouch calculi include observation for spontaneous passage, extracorporeal shockwave lithotripsy, percutaneous or endoscopic lithotripsy/lithotomy. Conclusions: Historically, the mean time to stone formation with nonabsorbable material (staples, Marlex mesh) is 34 months. None of the studies on use of nonabsorbable staples in urinary diversion has such a long follow-up. Until further studies with more appropriate observation time are completed, the use of nonabsorbable staples for continent and noncontinent urinary diversion should be discouraged.

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Reflux of a Staple after Kock Pouch Urinary Diversion: A Nidus for Renal Stone Formation

Cited by 10 publications

References 4 publications

Migration of a Hem-o-Lok clip to the renal pelvis after laparoscopic partial nephrectomy: A case report

Migration of a Hem-o-Lok clip to the renal pelvis after laparoscopic partial nephrectomy: A case report

Stone Formation from Nonabsorbable Clip Migration into the Collecting System after Robot-Assisted Partial Nephrectomy

Use of Nonabsorbable Staples for Urinary Diversion: A Step in the Wrong Direction

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