Laparoscopic Retrieval of a Retained Foreign Body Embedded in the Retroperitoneum

Abstract

A 38-year-old nulliparous woman without surgical history with enlarging uterine fibroids underwent laparoscopic myomectomy. A routine abdominal X-ray performed on postoperative day 2 showed a foreign body in the pelvis. Computed tomography revealed a metallic object, which was located outside the bowel. A planned laparoscopic exploration was undertaken on postoperative day 42. The foreign body was difficult to find, but unidimensional fluoroscopy revealed that it was embedded in the retroperitoneum. Local angiogenesis of the peritoneum, which rose on the right uterosacral ligament (USL), was noted in its location (Fig. 1). Laparoscopic retrieval of the foreign body was performed, along with an excision of surrounding connective tissue under the USL (Fig. 2), and it was confirmed that a 4 × 2 × 1 mm metallic object was removed (Fig. 3A). The object was confirmed to be a broken part of laparoscopic needle holder (Fig. 3B) which had been subsequently used in other surgeries following the index procedure. Fig. 2Laparoscopic image. The foreign body was retrieved by excising surrounding connective tissue en bloc. View Large Image Figure Viewer Download Hi-res image Fig. 3(A) A removed metallic object measuring 4 × 2 × 1 mm in size. (B) The jaw of laparoscopic needle holder. The object was confirmed to be a broken part (red arrow) of needle holder. View Large Image Figure Viewer Download Hi-res image