Doctors from Shanghai Ruijin Hospital successfully removed a steel nail lodged in the pelvis of a patient surnamed Zhou on November 30, 2023, the hospital announced on Tuesday.

The complex surgery involved medical teams from the gastrointestinal, orthopedics, and urology departments as the 3-centimeter-long nail was located dangerously close to major blood arteries.

The patient had previously undergone surgery elsewhere to repair his intestines, which were damaged by the nail following a workplace accident in late September 2023. The doctors then opted not to remove the nail as they feared the procedure might rupture the arteries around it.

The decision to remove the nail was later made by doctors in Ruijin Hospital after the patient complained that pain persisted even though the wound had healed.

"The CT scan showed that the tip of the nail was in the vertebrae, and the head of the nail was attached to the main trunk of the internal iliac artery. If the nail moved forward by 5 mm, it would very likely damage the internal iliac artery, causing serious bleeding and life-threatening consequences," explained Zang Lu, a chief surgeon at the gastrointestinal surgery department of the hospital.

To determine the precise position of the nail as well as the blood vessel and vertebrae, diagnostic radiology doctors performed a CT 3D reconstruction that involved 5,300 section images. Doctors from the orthopedics and urology departments then came together and formulated a surgical plan. It was decided that urologists would perform the right ureteral stent placement first before gastrointestinal surgeons performed a laparoscopic surgery to separate the intestines, ureters and large blood vessels around the nails. The last step was the removal of the nail by orthopedic doctors.

The operation went smoothly and the patient is now recovering well and does not require further treatment, said Zang.