Potential Indications for Intraoperative Conversion: “Lost Needle” during Laparoscopic or Robotic Pancreatoduodenectomy

Abstract

Despite controversy, robotic surgery's clinical application is increasing, particularly in complex procedures like pancreatoduodenectomy (PD). However, the lack of tactile feedback poses challenges. Surgeons operating robotic consoles must consider potential organ injury and suture breakage to avoid complications. We encountered 2 cases of lost needles during minimally invasive pancreaticoduodenectomy (MI-PD). We reflect on reasons and discuss methods for locating them, while considering preventive measures. MI-PD uses small sutures and thin threads, requiring careful needle movement. Medical staff should be aware of needle entry and exit. If a needle gets lost, surgery should be immediately halted to locate it, preventing the need for conversion and ensuring patient safety.