Use of a pacemaker magnet to remove a broken suture needle during a laparoscopic cholecystectomy

Abstract

Prompt removal of unintended surgical foreign bodies is essential for prevention of adverse consequences of retained surgical foreign bodies postop. Current practices utilizing radiographic images in combination with visual inspection and palpation to remove foreign bodies can lead to increased surgical times and tissue damage. A suture needle fragment broke off during a laparoscopic cholecystectomy performed on a morbidly obese adult female. After being unable to retrieve the fragment by increasing the midline incision by ~7 cm and undergoing an additional ~1 of intraoperative time, a pacemaker magnet wrapped in sterilized plastic was able to instantaneously remove the shard. Techniques utilizing magnetism could be researched and developed for the removal of surgical foreign bodies both intraoperatively and postop.

Broken Needle Embedded in the Body during Vascular Puncture

“…The incidence of a broken needle or needle breakage is not unknown. Broken needles have been reported during dental procedures [ 2 , 3 ], laparoscopy [ 4 ], surgical operation [ 1 ], percutaneous needle biopsy [ 5 ], endobronchial ultrasound-guided-transbronchial needle aspiration [ 6 ], antegrade suture passer of shoulder [ 7 ], bone biopsy [ 8 ], acupunctures [ 9 ], spinal anesthesia [ 10 , 11 ], and the injection of drugs [ 12 , 13 ]. Seven case reports of broken needles during various procedures were reported in 2021 from a PubMed ® search.…”

“…Titus at al. reported a broken suture needle during a laparoscopic cholecystectomy, with the free shard becoming lodged into the surrounding adipose tissue [ 4 ]. It was identified by intraoperative C-arm radiography and was removed using a pacemaker magnet [ 4 ].…”

“…reported a broken suture needle during a laparoscopic cholecystectomy, with the free shard becoming lodged into the surrounding adipose tissue [ 4 ]. It was identified by intraoperative C-arm radiography and was removed using a pacemaker magnet [ 4 ]. However, a broken needle embedded completely in the soft tissue can be removed by surgical exploration [ 1 , 13 , 14 ].…”

Looking for a needle in a haystack: Recovering tiny metal fragments of broken instruments during pediatric laparoscopic surgery

“…For small fragments, aimless searching will lead to displacement of fragments, and magnetic device is the recommended method. It is proved that magnetic device is a safe and reliable method to recover metal residues during operation [13,14] .Various magnetic devices available in the operating room are fully used by creative surgeons [15] . In our cases, magnetic sealing cap from non-disposable trocar was used.…”