It was reported that the physician was performing an intended ureteroscopy with laser lithotripsy on left kidney of the patient.The physician treated two stones out of three with holmium laser and removed the fragments.The physician¿s intent was to reposition the 3rd stone (1.1cm in size) from the lower pole of the kidney prior to treatment.The physician used the ncircle delta wire tipless stone extractor basket to extract the third stone from the calyx.He was able to deploy the basket around the stone, but was unable to extract it from the calyx due to its larger size, and was also unable to remove the stone from the basket.The physician had to cut the handle from the ncircle delta wire tipless stone extractor, remove the scope, and re-insert it next to the wire shaft of the basket in the ureter.He then attempted to use the laser to break up the stone or cut the basket to remove it but he was unable to deflect the scope enough to get clear access to the stone.The physician decided to stent the patient and to perform an extracorporeal shock wave lithotripsy (eswl) procedure so he can remove the basket once the stone is fragmented.The nitinol core of the basket (outer sheath removed) as well as the tip of the basket remained inside the patient.The proximal basket tip secured around the stone in the lower pole of the kidney, and the distal end of the wire was exiting the vagina, where it was covered and secured until the patient could be returned for an additional procedure.The patient was brought back in for an eswl on the next day.The eswl was unsuccessful in breaking up the stone, and at this time the device remained inside the patient.The physician is consulting with other providers.The physician's expectation is that he will have to schedule a percutaneous access to remove the device.The patient required an additional procedure due to this occurrence.According to the initial reporter, the patient did not experience any adverse effects due to this occurrence.
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