Aspiration of a dental implant driver: a rare endobronchial foreign body successfully removed by uniportal VATS bronchotomy

Abstract Foreign body aspiration in adults is uncommon and often presents with vague, misleading symptoms, which may resemble infection, asthma, or malignancy. This diagnostic challenge can delay appropriate management. While most cases occur in children, adult aspiration is typically associated with neurological impairment, trauma, or iatrogenic events such as medical or dental procedures. Chest imaging and careful clinical history are crucial for diagnosis. Rigid bronchoscopy remains the gold standard for retrieval, but when the foreign body is firmly impacted, alternative strategies are required. We describe a rare case of aspiration of a dental implant driver in a 40-year-old woman presenting with persistent cough and dyspnea. Radiology confirmed a metallic object lodged in the right lower lobe bronchus. Rigid bronchoscopy was attempted but unsuccessful due to the tight impaction. Uniportal video-assisted thoracoscopic surgery (VATS) was therefore performed. Intraoperative bronchoscopy guided a precise bronchotomy, allowing removal of the foreign body and primary closure of the bronchus. The patient’s postoperative recovery was smooth, and she was discharged on the third day without complications. This case highlights the role of uniportal VATS as a safe, minimally invasive alternative to thoracotomy when bronchoscopic extraction fails. The approach offers excellent visualization, facilitates precise bronchotomy, and reduces morbidity. Reports of dental implant components aspirated into the bronchial tree and managed with uniportal VATS are exceedingly rare. Our experience underscores the importance of considering uniportal VATS in selected adult patients, broadening the surgical armamentarium for complex foreign body aspirations.