During a dental treatment, the patient aspirated one hand an implantation screw of a dental implant into the bronchial system and on the other hand she swallowed the corresponding screwdriver. The screwdriver went via naturalis, but the screw had to be removed endoscopically, however.
After several failed attempts in various hospitals to recover the screw endoscopically, the patient was transferred to the pulmonology department of the hospital Natters (Tirol) to OA Dr. Martin Hackl.
The implant screw was already in the region of the Subsubsubsegment-Carina in the lingula and was remaining there eventually after the failed manipulation. Therefore under these circumstances with endoscopic intervention only small instruments can be used to recover the screw. First, the patient was intubated selectively in anesthesia with the rigid tube in the left main bronchus to prevent a loss of the foreign body to the other side.
Secondly, a bronchus-blocker for children was used to seal a fall protection issue with the screw (foreign body), therefore a small forceps was used to get it into place and the bronchus-blocker was inflated.
After that the screw had been mobilized through the working channel of a children bronchoscope with debris and trapped in a small bag, a small catheter, the X-Trac 10 catheter from the company Carmonja®. Subsequently, the screw has been safely removed via the rigid tube from the lungs. For this particular issue in the present very limited space there are only few instruments that can fulfill such a task. The X-Trac 10 is one of them, one of the best.
More Information can be found on the Olympus Website.