Introduction: Intraperitoneal retention of surgical instrument fragments may lead to severe complications. Therefore, such foreign bodies must be detected before surgery completion. We present a case with intraoperative breakage of a laparoscopic needle holder confirmed by a routine postoperative abdominal X-ray and review the literature regarding intraoperative laparoscopic instrument breakage. Case Report: A 58-year-old woman with stage IB1 cervical adenocarcinoma underwent a laparoscopic radical hysterectomy. Surgery was completed without major complications; however, an abdominal X-ray as a routine postoperative examination revealed a radiopaque shadow of approximately 3 mm corresponding to a broken part of the tissue-pad of the laparoscopic needle holder tip. It was successfully removed using laparoscopy with fluoroscopic guidance without further complications. According to the literature review, most of the instrument breakage were noticed during surgery as they were either obvious or impaired function. In our case, since the detached foreign body was extremely small and did not significantly affect needle holder function, it remained unnoticed until the postoperative X-ray was taken. Conclusion: Postoperative abdominal X-rays identify instrumental fragments infrequently; however, they may help detect intraperitoneal retention of foreign bodies and avoid serious complications following laparoscopic surgery.
The management of vaginal delivery during the COVID-19 pandemic remains unclear due to lack of information on labor characteristics. We aimed to clarify the effects of COVID-19 on the progression of vaginal labor. The single-institutional and observational study of COVID-19 women in pregnancy (COVID-19 group, n = 50) delivering from 2020 to 2022, was conducted. Patients’ backgrounds, perinatal outcomes, labor characteristics (labor time and Bishop score), and the details of maternal COVID-19 were analyzed and compared with non-COVID-19 pregnant women (control group, n = 258). The COVID-19 group showed rapidly progressing labor without adverse effect. The 1st and 2nd stage of labor time, and labor time after rupture of membrane were significantly shorter in the COVID-19 group than in the control group (P < 0.01; P < 0.01; and P < 0.05, respectively). The COVID-19 group had a higher Bishop score on initiation of labor (P < 0.01). Precipitous delivery in the COVID-19 group also significantly increased (P < 0.05). These results indicated that COVID-19 in pregnancy can affect the progression of labor rapidly. This is the first report focusing on the characteristics of labor progression in COVID-19 women, indicating that COVID-19 can affect the progression of labor without complication.
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