We are proud to share a groundbreaking case, where we successfully managed a rare surgical complication endoscopically. A 49-year-old female patient, previously operated on for fissurectomy and rectal mucopexy, presented with a broken suture needle that had migrated into the pararectal space. A CT abdomen with rectal contrast confirmed the needle’s location in the rectovaginal pouch, completely outside the rectal wall. During a sigmoidoscopic examination, previously placed sutures were identified, but the needle was not visible in the lumen. Using Endoscopic Ultrasound (EUS), we marked the needle’s position over the mucosa. We then created a submucosal tunnel 4 cm proximally and performed a myomectomy to retrieve the broken needle from the pararectal space. The tunnel was closed using endoclips, and the patient was discharged on the same day.
This case highlights the potential of advanced techniques like third-space endoscopy, allowing us to explore and operate beyond the gastrointestinal wall boundaries, thus avoiding larger surgical interventions.
