A Laparoscopic Magnet-Assisted Technique for Retrieval of Retained Peritoneal Foreign Bodies: Lessons from a Case Report

Background and Clinical Significance: Percutaneous endoscopic gastrostomy (PEG) is widely used to provide long-term enteral nutrition in neurologically impaired children. Although generally safe, inadvertent visceral organ damage during placement may result in rare, serious complications like gastrocolic perforation. Subsequent laparoscopic repair introduces further subtle risks, including the retention of broken surgical sharps due to the physical limitations of minimally invasive environments. Finding and extracting these small ferromagnetic components poses a severe technical dilemma, often prolonging anesthesia or forcing conversion to open laparotomy. Magnet-assisted techniques may potentially serve as a rapid, low-impact rescue alternative in selected circumstances. Case Presentation: A 14-year-old boy with severe neurodevelopmental deficits (Dandy–Walker malformation, cerebral palsy, refractory generalized epilepsy) presented with severe peritonitis two weeks following a PEG tube placement. Urgent diagnostic laparoscopy identified multi-site visceral injuries: a through-and-through perforation involving both the anterior and posterior walls of the transverse colon alongside an anterior gastric perforation, secondary to severe colon interposition. While laparoscopically repairing these visceral defects, a 26-mm curved suturing needle fractured inside a 10-mm working trocar, and the sharp tip disappeared into the peritoneal environment. Initial thorough inspection failed to localize the sharp. Postoperative abdominal radiography verified the fragment’s location within the left upper quadrant. During a secondary re-exploration, an improvised magnetic delivery system (comprising small sterile neodymium spheres sealed within a surgical glove finger) was passed through a trocar to rapidly target, capture and extract the fragment. The subsequent course was complicated by adhesive mechanical small-bowel obstruction, requiring further laparoscopic adhesiolysis before successful stabilization. Conclusions: Concurrent gastrocolic organ perforation and intra-operative instrument fracturing represent a concurrent complication in children with complex comorbidities. This case highlights the biomechanical vulnerabilities of minimal-access closures and demonstrates the clinical feasibility of an improvised, glove-contained magnetic capture array, suggesting it may represent a useful, low-impact rescue option to locate and remove retained sharps without open surgery.