Laparoscopic retrieval of sharp foreign body: An innovative approach.

Background: Laparoscopy is a relatively new surgical approach in developing countries. Migrated foreign bodies into the body cavities could be very distressing to patients, relations and caregivers. There are paucity of migrated Steinmann pin and laparoscopic retrieval methods in literature.

Aim: An innovative approach of laparoscopic retrieval of migrated sharp foreign body (Steinmann pin).

Methods: A two-port technique was used to retrieve the pin. These ports consisted of optical supra-umbilical port (10 mm) and left iliac fossa port of 10 mm. They were aligned in the direction of sharp end of the foreign body, to aid retrieval of the Steinmann pin. This procedure was performed on a 34-year-old man who presented with migration of Steinmann pin into abdominal cavity. He had open reduction of old unreduced left posterior hip dislocation. A Steinmann pin with a diameter of 4.5 mm and length of 140 mm was passed through the greater trochanter to the acetabular roof. The protruding end of the pin ought to have been bent. Three weeks post-surgery, the pin migrated. Physical examination revealed vague tenderness over supra pubic region. A hard pointed object was palpable in the right iliac fossa. Abdominal X-ray and ultrasound were suggestive but not definite for pin location.

Results: A sharp Steinman pin was retrieved from the abdominal cavity using laparoscopy.

Conclusion: Migration of Steinmann pin is unusual. Laparoscopy is an innovative approach to foreign body retrieval. This could help reduce the morbidity that may be accompanied by other modalities such as open approach.