title: Laparoscopic removal of migrated intrauterine device embedded in intestine.
abstract: BACKGROUND
  The intrauterine device (IUD) is a popular family planning method worldwide. Some of the complications associated with insertion of an IUD are well described in the literature. The frequency of IUD perforation is estimated to be between 0.05 and 13 per 1000 insertions. There are many reports of migrated intrauterine devices, but far fewer reports of IUDs which have penetrated into the small intestine.
  
  
  METHODS
  Herein we report a case of perforated intrauterine device embedded in the small intestine. By using a wound protector retraction device, and fashioning the anastomosis extra-corporeally, we were able to more easily perform this laparoscopically. This left the patient with a quicker recovery, and a better cosmetic result.
  
  
  CONCLUSIONS
  IUD perforation into the peritoneal cavity is a known complication, and necessitates close follow-up. Most, if not all, should be removed at the time of diagnosis. In the majority of previously reported cases, removal was done through laparotomy. Even in cases where removal was attempted laparoscopically, many were later converted to laparotomy. Surgeons should be aware of different techniques, including using a wound protector retraction device, in order to facilitate laparoscopic removal.
authors.affiliation: Department of Surgery, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Amir A
authors.initials: AA
authors.lastname: Rahnemai-Azar
authors.affiliation: Department of Surgery, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Tehilla
authors.initials: T
authors.lastname: Apfel
authors.affiliation: Department of Surgery, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Rozhin
authors.initials: R
authors.lastname: Naghshizadian
authors.affiliation: Department of Surgery, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: John Morgan
authors.initials: JM
authors.lastname: Cosgrove
authors.affiliation: Department of Surgery, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Farkas
mesh_terms: D000328:Adult; D020878:Device Removal / Q000379:methods*; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000293:injuries*; D058736:Intrauterine Device Migration / Q000009:adverse effects*; D010535:Laparoscopy / Q000379:methods*
keywords: Intrauterine device; Laparoscopy; Migration; Small intestine