laparoscopy is widely used as a tool in many clinical situations allowing for diagnosis and/or surgical management in a minimally invasive fashion . nonetheless , attention to surgical technique is paramount to avoid both short and long term complications . a 32-year - old woman had a laparoscopy and a reported left salpingoophorectomy for benign disease of the ovary in september , 1994 . shortly thereafter , in january , 1995 , she was diagnosed with an intrauterine pregnancy and delivered in october of 1995 by spontaneous vaginal delivery . however , at the time of laparotomy , the patient was found to have a retained foreign body from her prior laparoscopy in the right lower quadrant with a pelvic abscess and evidence of prior right salpingoophorectomy . although laparoscopy is usually done on an outpatient basis , complications can manifest several weeks or months later . this case illustrates and reminds us of the importance of adherence to surgical laparoscopic principles . these include direct visualization when removing equipment and a complete count of surgical instrumentation to confirm the integrity of such at the end of each procedure . operative time is acceptable and recovery periods are significantly less than in open procedures with no significant difference in morbidity and/or mortality , even in pregnancy . a 32-year - old white woman presented to the gynecologic emergency room on november 21 , 1995 , complaining of tenderness and swelling of her right lower quadrant for three days . at that time she was four weeks postpartum from a spontaneous vaginal delivery . her surgical history was significant for a laparoscopy done in september of 1994 in vienna , austria , where a left salpingoophorectomy reportedly was performed for an ovarian cyst . pelvic examination revealed a normal uterus with a right adnexal mass approximately 8 cm in size , and exquisitely tender to palpation . abdominopelvic ct scan revealed a 5.5 cm  4 cm  5.3 cm right adnexal mass , inflammatory in nature . in addition to this , a 4.3 cm  6 cm  3.4 cm mass was superior to the first mass , in the right lower quadrant , and also inflammatory in nature . the patient was taken to the operating room by the gynecologic service for an exploratory laparotomy . intraoperatively , a normal left adnexae was found , not consistent with the patient 's history of left salpingoophorectomy . on the right side there was a large , 10 cm  12 cm inflammatory mass with the appearance of an abscess . clearly above this mass , a 3 cm  2 cm portion of synthetic tubing was found enveloped by omentum ( figure 1 ) . a partial omentectomy and removal of foreign body was performed , along with an excision of the right pelvic abscess and appendectomy . antibiotics were continued until the patient was afebrile for 48 hours . by postoperative day number five the patient was tolerating a regular diet and ambulating without assistance . the patient was seen in the postoperative clinic at four weeks and was doing well with no specific complaints . pathology reports revealed the foreign body to be synthetic tubing and the pelvic mass to be soft tissue with extensive scarring and acute suppurative inflammation with focal abscess formation . a 32-year - old white woman presented to the gynecologic emergency room on november 21 , 1995 , complaining of tenderness and swelling of her right lower quadrant for three days . at that time she was four weeks postpartum from a spontaneous vaginal delivery . her surgical history was significant for a laparoscopy done in september of 1994 in vienna , austria , where a left salpingoophorectomy reportedly was performed for an ovarian cyst . pelvic examination revealed a normal uterus with a right adnexal mass approximately 8 cm in size , and exquisitely tender to palpation . abdominopelvic ct scan revealed a 5.5 cm  4 cm  5.3 cm right adnexal mass , inflammatory in nature . in addition to this , a 4.3 cm  6 cm  3.4 cm mass was superior to the first mass , in the right lower quadrant , and also inflammatory in nature . the patient was taken to the operating room by the gynecologic service for an exploratory laparotomy . intraoperatively , a normal left adnexae was found , not consistent with the patient 's history of left salpingoophorectomy . on the right side there was a large , 10 cm  12 cm inflammatory mass with the appearance of an abscess . clearly above this mass , a 3 cm  2 cm portion of synthetic tubing was found enveloped by omentum ( figure 1 ) . a partial omentectomy and removal of foreign body was performed , along with an excision of the right pelvic abscess and appendectomy . antibiotics were continued until the patient was afebrile for 48 hours . by postoperative day number five the patient was tolerating a regular diet and ambulating without assistance . the patient was seen in the postoperative clinic at four weeks and was doing well with no specific complaints . pathology reports revealed the foreign body to be synthetic tubing and the pelvic mass to be soft tissue with extensive scarring and acute suppurative inflammation with focal abscess formation . complications from laparoscopy such as bleeding or structural injury can usually be recognized immediately intraoperatively . what makes this case unusual is the time interval ( 14 months ) and the fact that the patient had an intervening pregnancy . it is theorized that the device must have been defective and when removing the sleeve thread anchor , probably with the trocar as a whole unit , a portion of it was sheared off and remained intraabdominally . the presentation of the patient was also atypical in that clinical evidence pointed to appendicitis . it is unclear whether the pelvic abscess was directly related to the retained foreign body or if there was another etiology . the authors favor the foreign body as the source since laparotomy revealed normal bowel and absence of the right adnexae in this patient . it is strongly suspected that the presence of a foreign body associated with the physiologic changes in the postpartum period combined to provide a favorable environment for abscess formation . in the literature , both shortand long - term complications exist and precautions to avoid these should be paramount . although most complications are related to hemorrhage , bowel or genitourinary injury , the rare case of a retained foreign body from laparoscopic equipment must be considered . the trend to move to one - piece disposable units where the trocar is self - retaining is one step in the direction of both simplification of laparoscopic procedures and prevention of postoperative complications .