Postoperative small bowel obstruction secondary to single malformed staple following laparoscopic total abdominal colectomy

Abstract

Surgical staplers are ubiquitous in gastrointestinal surgery, especially laparoscopy. Intraperitoneal staples are designed to be inert and are generally regarded as benign; however, complications from primarily malformed staples can rarely occur. Here, we present a case of early mechanical postoperative small bowel obstruction due to a surgical staple following laparoscopic total abdominal colectomy and end ileostomy creation performed for medically refractory ulcerative colitis. Management consisted of diagnostic laparoscopy and careful extraction of a malformed surgical staple tethering a loop of small bowel to the rectal stump. Eight similar cases following gastrointestinal surgery have been identified in the literature, all occurring in the first 2 weeks following laparoscopic appendectomy. To our knowledge, this is the first case described following laparoscopic total abdominal colectomy, with high-grade small bowel obstruction at the level of the rectal stump staple line.