Paravesical gossypiboma following inguinal herniorrhaphy: Laparoscopic retrieval

Abstract

Retained surgical sponge (gossypiboma) following an inguinal herniorrhaphy is a rare condition and may cause medicolegal problems. Differential diagnosis for the lesion should be made meticulously. We report a case of a 45-year-old man who had a herniorrhaphy about 8 years previously. He presented one episode of painless gross hematuria. Laboratory and imaging studies excluded any significant lesion in the urological organs. Abdominal CT scan demonstrated a heterogeneous neoplasm of 4 cm in size in the left paravesical area that was retrieved laparoscopically. Abdominal CT and clinical suspicion are helpful for diagnosis. Laparoscopy may be used to confirm the diagnosis and to remove the retained surgical gauze, and considered as an alternative therapy for some selected patients.

Keywords: Gossypiboma; herniorrhaphy; laparoscopy.

Figure 1

Abdominal CT showing a round, heterogeneous and low dense mass with a thin, hyperdense capsule at the left paravesical area

Figure 2

Laparoscopy showing a paravesical tumor lateral to the left side of the urinary bladder. (a) Following sharp dissection on the tumor capsule, yellowish seropurulent fluid being drained outside the tumor. (b) A surgical gauze being removed from the tumor. (c and d)