Laparoscopic Management of a Frameless Intrauterine Device-GyneFix® Embedded in the Mesentery of the Ileum

Özet

GyneFix® is a small, frameless, armless, flexible intrauterine device. The proximal end contains a knot that is anchored in the uterine fundus using a special apparatus. A 31-year-old woman presented with abdominal cramps ten days after GyneFix® insertion. Transvaginal ultrasonography was unsuccessful in locating the intrauterine device therefore a direct X-ray sonogram of the abdomen while standing was performed. The X-ray sonogram of the abdomen showed the intrauterine device in the right quadrant. An exploratory laparoscopy was performed and showed that the intrauterine device perforated the uter-ine fundus and was embedded in the mesentery of the ileum. The intrauterine device was removed with-out complication. Although the reported complication rates are very low for GyneFix®, practitioners should be well trained and should be aware of such complications that could lead to bowel resection. We report the first case of a GyneFix®- Intrauterine device presenting with uterine perforation and nearly intestinal perforation since its recent introduction into the Turkish market.