Hem-o-Lok clip migration causing ureteral stone formation after ureteroplasty for retrocaval ureter: A case report

The Hem-o-Lok clip, a permanent polymer ligation device, is rarely associated with long-term complications like migration and tissue perforation. A 57-year-old male presented with right flank pain and ureteral obstruction. Imaging revealed a stone and severe hydronephrosis. Ureteroscopy identified an embedded Hem-o-Lok clip as the stone nidus. After failed endoscopic retrieval, robotic-assisted laparoscopic segmental ureterectomy with end-to-end anastomosis was successfully performed to remove the clip and reconstruct the ureter. This case highlights that migrated Hem-o-Lok clips can serve as a lithogenic nidus, causing ureteral obstruction. Standardized clipping technique and long-term follow-up are essential to mitigate such risks.