TITLE:
Should the Surgical Instrument Parts That Are Broken and Remain in the Distance of the Disc Be Removed? Should It Be Quit? A Case Report
AUTHORS:
Saim Kale, Mehmet Tokmak, Mehmet Daimoglu
KEYWORDS:
Lumbar Microdiscectomy, Complication, Pituitary Disc Rongeur, Surgical Instrument Fracture
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.12 No.2,
April
27,
2022
ABSTRACT: Background
and Aim: Lumbar posterior open microdiscectomy is a procedure
that is widely used to treat lumbar disc diseases. These operations have a low
risk of complications. It is unusual for the tool to break and remain in the
intervertebral space during surgery. In this situation, we wanted to provide a
set of suggestions based on our research of the literature on pituitary forceps
blade fractures and the procedure for removing the fractured portion from the
disc space during lumbar posterior open microdiscectomy surgery. Case Presentation: 10 days ago, a 37-year-old female patient presented to our clinic
complaining of low back pain, left leg pain, and left foot weakness. A
diagnosis of lumbar disc herniation necessitating surgery was obtained
following neurological and radiographic examinations. The patient was advised to
have surgery. The patient had standard lumbar microdiscectomy surgery. However,
the tip of the pituitary forceps was broken during disc removal and remained in
the L5-S1 disc space. The scope confirmed that the alien object was in space.
After the evaluation, it was decided to remove the piece of instrument that was
broken and remained in the disc space. The broken surgical handpiece was
removed and documented under fluoroscopy. Additionally, it was forwarded to the
technical unit for examination. Conclusion: A few case reports in the literature
describe a surgical tool piece fracture that remained in the disc distance of
the lumbar microdiscectomy. Complication management may be time-consuming and
risky. Such a complication should be addressed and resolved appropriately
because this situation might have detrimental terms on surgical risks and the
legal procedure.