Antegrade impalement of the rectum by a foreign body: a case report of a successful transanal extraction using the transanal single port (TAMIS) technique

  • J. P. Bulte
  • S. H. E. M. Clermonts
  • D. D. E. ZimmermanEmail author
Trick of the Trade


Patients with retained rectal foreign bodies (RFB’s) are not an uncommon occurrence in most emergency departments, and can sometimes constitute a considerable clinical challenge. Many simple and/or complex manoeuvres have been described for removing such RFB’s. A technique that is sometimes mentioned, but rarely described in the literature is the use of a transanal minimally invasive surgery (TAMIS) procedure. We describe the case of a patient that inserted a punch tool, that required a TAMIS to be safely removed.

Case report

A 70-year-old male with a history of schizophrenia presented to the emergency department after rectal insertion of a punch tool he used to relieve his constipation. He was in no apparent distress, abdominal examination was unremarkable. Hemodynamic parameters were normal. At digital rectal examination the foreign body was not palpable. A plain abdominal X-ray showed a punch tool, projecting obliquely, cranial over the sacral bone (Fig. 1). Rigid...



The authors thank mrs M. ter Meer and mr. J. Pistorius for their assistance in image acquisition and processing.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study contains only retrospective data, and is in full compliance with local laws and guidelines. No formal ethical review was required.

Informed consent

Written informed consent was obtained from the patient for publication of this Case Report and all accompanying images. A copy of the written consent is available for review by the Editors-in-Chief of this journal.


  1. 1.
    Cawich SO, Thomas DA, Mohammed F, Bobb NJ, Williams D, Naraynsingh V (2017) A management algorithm for retained rectal foreign bodies. Am J Mens Health 11(3):684–692. CrossRefPubMedGoogle Scholar
  2. 2.
    Kurer MA, Davey C, Khan S, Chintapatla S (2010) Colorectal foreign bodies: a systematic review. Colorectal Dis 12(9):851–861. CrossRefPubMedGoogle Scholar
  3. 3.
    Wu JH, Zhang HY, Xia Y, Jiang LQ, Yuan Y, Xu SG, Zhou PY (2018).A novel technique for minimally invasive removal of a foreign body in the rectal wall Tech Coloproctol. 22:313–317. (Epub 2018 Apr 3)
  4. 4.
    Cawich SO, Mohammed F, Spence R, Albert M, Naraynsingh V (2015) Colonic foreign body retrieval using a modified TAMIS technique with standard instruments and trocars. Case Rep Emerg Med 2015:815616. CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Leonard D, Colin JF, Remue C, Jamart J, Kartheuser A (2012) Transanal endoscopic microsurgery: long-term experience, indication expansion, and technical improvements. Surg Endosc 26(2):312–322. CrossRefPubMedGoogle Scholar
  6. 6.
    Alessandro C, Daniela M, Michele M, Andrea T, Gianmarco G, Massimo S, Orazio Z, Fabio G, Giuseppe T (2012) Glove port technique for transanal endoscopic microsurgery. Int J Surg Oncol 2012:383025. CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Hompes R, Ris F, Cunningham C, Mortensen NJ, Cahill RA (2012) Transanal glove port is a safe and cost-effective alternative for transanal endoscopic microsurgery. Br J Surg 99(10):1429–1435. CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of SurgeryElisabeth-TweeSteden (ETZ) HospitalTilburgThe Netherlands

Personalised recommendations