Laparoscopic removal of a foreign body in the pelvic cavity through one port using a flexible cholangioscope

Abstract

Background: More than two trocar ports 12 mm in diameter were usually used to remove a foreign body from the peritoneal cavity using laparoscopic surgery. We designed a method of laparoscopic removal through a single port 5 mm in diameter and a flexible cholangioscope.

Patients and methods: The patient had a ventriculoperitoneal shunt (V-P shunt) catheter implanted for hydrocephalus of unknown cause in his 40s. Endoscopic marsupialization of the third ventricle was performed because of functional failure of the V-P shunt catheter 7 years after the implantation. A falling off of the V-P shunt catheter into the pelvic space was detected, and laparoscopic removal of the V-P shunt catheter was performed. A laparoscope was inserted through a trocar port 5 mm in diameter to confirm the location of the V-P shunt catheter following replacement of the flexible cholangioscope to grasp the catheter. The catheter was held using a snare catheter through the cholangioscope. The V-P shunt catheter was removed by pulling through the trocar port with the flexible cholangioscope.

Conclusion: Laparoscopic removal is a good technique for removal of a foreign body in the peritoneal cavity. It enables one-port laparoscopic removal using a flexible cholangioscope.