Thulium laser to endoscopically manage a rectal erosion and intraluminal mesh migration after ventral rectopexy

Rectal erosions after ventral rectopexy (VR) is an uncommon but challenging adverse event and can be associated with partial migration of the mesh into the intestinal cavity. Re-do surgery is difficult and often provides colostomy and/or anterior rectal resections. However, no alternative solutions are described in the available literature. An 82-year-old woman presented to our hospital for rectal erosion and intraluminal migration of the mesh placed at a 1-year laparoscopic VR. We performed an innovative totally endoscopic approach, using thulium laser and two endoscopes, that led to a successful removal of the mesh. The described mini-invasive technique can be an effective alternative to surgery in tertiary referral centres.

Radiopaque gauze migrating into the intestine – a case presentation

Despite the meticulous monitoring of surgical material using the WHO Surgical Safety Checklist, gauze sponges and surgical instruments continue to be left inside patients after operations. It is an important issue for surgeons, operating room nurses and the entire medical team. Foreign bodies retained in the system may cause many disorders and result in potentially serious consequences for patients, including death. As well as this, further procedures are needed to remove them and treat any subsequent complications. Retained foreign bodies are rare, but intraluminal migration of the foreign body should be considered extraordinary. Very few cases have been reported so far. The authors believe that it is desirable to perform a wide range of diagnostic imaging in such cases.

Complete Intraluminal Migration of Surgical Sponge (Gossypiboma) With Complete Intestinal Obstruction

A 33 years aged gentle lady presented with the features suggestive of acute intestinal obstruction due to complete intraluminal migration of a laparotomy sponge, five years after open cholecystectomy in a private clinic. Contrast enhanced CT scan of whole abdomen revealed an elongated intraluminal mass in the distal ileum causing intestinal obstruction. Exploratory laparotomy revealed circumvented loop of ileum with intraluminal mass sized around 6x12 cm in the terminal ileum. Enterotomy delivered a surgical sponge with no external or internal communication. Though intraluminal migration of retained surgical sponge has often been reported. But complete migration with features of intestinal obstruction is rare.KYAMC Journal Vol. 4, No.-1, July 2013, Page 362-365

Intestinal Obstruction and Ileocolic Fistula due to Intraluminal Migration of a Gossypiboma

Gossypiboma refers, as a term, to a retained surgical sponge. It is considered as a rare surgical complication which can occur despite precautions. We report a case of a 36-year-old woman who was admitted to our surgical department with symptoms of abdominal pain associated with episodes of nausea and vomiting that lasted for 2 months. Six months ago she had undergone a cesarean section in a private clinic. Computed tomography revealed a high-density mass occupying a portion of the intestinal lumen, which was reported as a “calcified parasite.” The patient was subjected to laparotomy. The intraoperative findings included signs of obstructive ileus and ileosigmoid fistula and a large sponge was found at the resected portion of the small intestine. Although gossypiboma is a rare entity, it should be included in the differential diagnosis.

Transgastric migration of gossypiboma: A preventable complication

Gossypiboma is term given for retained piece of cotton/sponge during surgery. The incidence of gossypiboma has described as 1 in 1000-3000 surgeries. Incidence is underestimated because of underreporting due to fear of medico-legal litigation and extreme criticism by media. Intraluminal migration is a rare complication of gossypiboma. Small intestine is most common intraluminal site followed by duodenum. Here, we report sixth case of transgastric migration of gossypiboma.