During a laparoscopic total colectomy, covidien circular stapler was fired and removal of the stapler was difficult as some resistance was met.The staple was eventually withdrawn, however, the anvil was retained in the lumen.In addition, some bleeding occurred in the mesentery and was controlled by clips.To remove the anvil, the flexible sigmoidoscope was introduced and an endoscopic net was used without success.An endo loop was introduced into the rectum without success as well.Finally, using a biopsy forceps, the donut was grasped and the anvil removed guided by laparoscopy.Patient was taken back to surgery three days later with anastomotic leak.
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