Patient with a paraesophageal hernia had laparoscopic repair with nissen fundoplication.The hernia involved at least 50% of her stomach.During the fundoplication, the surgeon used three stitches of 0 silk on the endostitch device.Each stitch incorporated a bite of the left leaf of the wrap.During the first bite through the left leaf of the wrap, a needle on the endostitch broke in such a way that half of it remained within the endostitch device and the suture did not pass through the gastric wall.The other half of the needle was not retrieved.It was believed to be within the gastric wall.Efforts were made to find the 2 mm needle fragment, but it was not seen in the abdomen.Surgeon is aware and declined x-ray or further intervention to retrieve the fragment.Patient went to pacu in satisfactory condition and was discharged home the next day.Remainder of endostitch and needle was not saved.
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