# Entrapped surgical needle In the valveless AirSeal trocar: A case report and literature review

## TL;DR

A surgical needle was lost in a valveless AirSeal trocar during a robotic procedure and was found using retrograde inspection and X-ray.

## Contribution

The paper introduces a method for locating lost instruments in valveless trocars using retrograde inspection and targeted radiography.

## Key findings

- A missing needle was located within the AirSeal trocar using backward endoscopic inspection.
- X-ray imaging of the trocar confirmed the presence of the needle.
- Retrograde inspection can prevent unnecessary delays in surgery.

## Abstract

Valveless trocars like AirSeal system are maintain a stable pneumoperitoneum and reduce instrument friction.

A 65-year-old man's robotic radical cystectomy was complicated by a missing needle while using AirSeal system. The needle was detected via backward inspection using the endo camera inserted through the trocar, tip at its most distal end let the visualization of the needle within the air channels and confirmed with a trocar X-ray.

Our findings suggest that retrograde inspection and targeted radiography of the trocar, prior to patient imaging, can be helpful in locating the lost needle and prevent prolongation of surgeries.