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2025, Number 1-4

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Rev Mex Cir Endoscop 2025; 26 (1-4)

Reconversion to laparoscopy to locate a lost gauze after conversion from laparoscopic cholecystectomy to open cholecystectomy. Case report

Huerta-Gasca KG

Language: Spanish
References: 18
Page: 50-54
PDF size: 2387.37 Kb.


ABSTRACT

Introduction: this case describes a difficult laparoscopic cholecystectomy converted to open surgery with retention of a surgical gauze not localized by open approach, with subsequent reconversion to laparoscopy for its location and removal. It highlights laparoscopy as a key approach in the removal of foreign bodies when other methods fail, and emphasizes the importance of prevention in complex surgeries. Clinical case: a 22-year-old male patient, with no relevant clinical history, scheduled for laparoscopic cholecystectomy. During surgery, there was hemorrhage that was difficult to control in the gallbladder bed and Tachycardia as a suggestive of shock, which led to conversion to open surgery. After completing the procedure, one lost gauze was identified, which was not located by manual examination or X-Ray. It was decided to reintroduce laparoscopic instruments to locate the missing gauze. Using a 360° vision, finding the gauze under the left hepatic lobe. The patient had an adequate evolution and was discharged 24 hours later without complications. Conclusion: this case underscores the effectiveness of laparoscopy in locating foreign bodies, when other methods have failed. Laparoscopy is critical to avoid serious complications and reduces the need for additional procedures.


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