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Retained Needle Following Transanal Hemorrhoidal Dearterialization.
Valerio Celentano1, Anjan Banerjee, Federico Luvisetto
1Colorectal Unit, Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth, United Kingdom.
Diseases of the Colon and Rectum
|October 10, 2017
Summary
A rare complication of transanal hemorrhoidal dearterialization, a retained needle, was successfully removed using intersphincteric dissection. This technique offers a viable alternative for needle retrieval when transanal methods fail.
Area of Science:
- Colorectal Surgery
- Surgical Complications
- Minimally Invasive Procedures
Background:
- Transanal hemorrhoidal dearterialization (THD) is a common procedure for hemorrhoid treatment.
- A retained surgical needle is a rare but serious complication.
- This case describes the first instance of a retained needle during THD.
Observation:
- A spinal needle was used to localize a retained needle 7 cm from the anal margin.
- Intersphincteric dissection was performed via a 3-cm perianal incision.
- The needle was located within the muscular layer and retrieved intact.
Findings:
- Successful retrieval of the retained needle using intersphincteric dissection.
- Postoperative recovery was uneventful, with significant symptomatic improvement.
- No anal fistula or residual foreign body was detected on follow-up examination.
Implications:
- X-ray guidance aids in the 3D localization of retained surgical needles.
- Intersphincteric dissection is a reliable alternative to THD for needle retrieval.
- Minimizing palpation attempts prevents deeper displacement of the foreign body.
