Migration of Hem-O-Lok Clip into the Bronchus after Video-Assisted Thoracoscopic Surgery accompanied by Pseudomonas aeruginosa：A Case Report

Background: The Hem-O-Lok clip is commonly employed as a surgical consumable for occluding blood vessels and bronchi during Video-Assisted Thoracoscopic Surgery (VATS). However, there is a paucity of literature regarding the potential complications associated with its use. Case presentation: This article presents a case report on the successful management of bronchiectasis accompanied by massive hemoptysis through VATS. The Hem-O-Lok clip used during the operation shifted into the bronchus between the right middle lobe and posterior segment of the right lower lobe. Enhanced CT evaluation confirmed that Hem-O-Lok clip was far from blood vessels and could be safely removed. Subsequently, the Hem-O-Lok clip was successfully retrieved through bronchoscopy, and symptomatic treatments including anti-infectives and bronchodilators were administered, leading to a significant amelioration of respiratory symptoms. Conclusion: This article presents a case of postoperative migration of a Hem-O-Lok clip into the tracheal cavity in a patient undergoing VATS for bronchiectasis with massive hemoptysis, accompanied by long-term chronic infection caused by Pseudomonas aeruginosa . It offers a valuable opportunity to gain practical experience in the application of Hem-O-Lok clips during VATS, while also facilitating risk prediction and evaluation for post-operative detachment.