Patient for removal of calculus in right kidney.During procedure, a dimension basket was used to retrieve stone fragments.Due to considerable difficulty in distal right ureter in removing basket with gentle pressure, the basket was cut and it was left in place.A semi-rigid ureteroscope was inserted and gentle traction resulted in the basket fracture and it remained intraureteral.Fragments of basket were retrieved; tongs of basket remained.Various other maneuvers attempted to retrieve tongs of basket but were unsuccessful.Due to poor visualization from the ureteral manipulation and trauma and increased bleeding and edema, it was determined to be no longer safe and decision was made to abort procedure and place a stent.Fragments of stone and tongs of basket remained in patient's ureter.Stent to remain in place for passive dilation with plan to bring patient back to operating room in near future for retrieval of additional stone fragments and additional iatrogenic fragments of basket.Patient returned to operating room for cystoscopy, ureteroscopy with lithotripsy, basket stone extraction and insertion of ureteral right stent due to calculus of right kidney.Retained foreign body was successfully retrieved and removed from patient.Peer review conducted and concluded that it is unclear why basket broke during first procedure; basket sent back to manufacturer for further evaluation.
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