1. Clinical data and methods 1.1 General data The group admitted a total of 13 patients with intra-abdominal foreign bodies, all women, aged 28-65 years, average 38 years, 3 cases had menopause, 2 cases had a history of cesarean section; among the abdominal foreign bodies, 12 cases had ectopic IUDs (5 cases had T-rings, 7 cases had metal round rings), the time of IUDs ranged from 24h to 30 years, 9 cases had a history of failed IUD removal, and the IUDs were found to be outside the uterine cavity by ultrasound after surgery. In one case, the IUD was found to be free on physical examination, in two cases, the IUD was inserted during the puerperium and the IUD was found to have penetrated outside the uterine cavity during the operation, and in all of the above cases, the IUD was confirmed to be displaced in the abdominal cavity by radiography. The other case was our laparoscopic resection of the adnexa, and due to the improper use of the method, the ultrasound tip for laparoscopy was found to be missing 1 cm after surgery, and intraoperative X-ray machine fluoroscopy confirmed that the severed head was left in the abdominal cavity. Wang Caizhi, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China 1. 2 Methods The operation was performed using a Stryker O° laparoscope under general anesthesia supervision, with the head in a low-to-high position, without a uterine lifter, and Veress puncture at the lower edge of the umbilical chakra, with CO2 pneumoperitoneum at a pressure of 15 mm Hg (1 mmhg=0.133 kPa). The laparoscope was placed 10 mm below the umbilicus, and 5 mm trocar was inserted at 2-3 cm medial to the anterior superior iliac spine to probe for foreign body; after finding the foreign body, the surrounding adhesions were separated and removed by clamping, and for the formation of inflammatory wrapping or pus accumulation, saline was used to fully flush it out during the operation. The C-arm X-ray machine can be used intraoperatively to help locate the foreign body if it cannot be found by laparoscopy. The skin incision was closed intradermally with a 0-gauge Dexon absorbable suture, and no suture removal was required. The ectopic IUDs in 12 cases were successfully removed laparoscopically in 9 cases (3 cases embedded in the uterine corners, 3 cases in the anterior uterine wall, 2 cases in the posterior uterine wall, and 1 case in the fundus); in 3 cases outside the uterus, only 1 case (free in the rectal recess) was removed laparoscopically, and 1 case wrapped in the greater omentum was removed with the help of C-arm X-ray machine positioning. The laparoscopic surgery time ranged from 5 min to 2 h. In one case, the surgical gauze was successfully separated and removed under laparoscopy, and the laparoscopic surgery time was 15 min. It was finally removed from the interstitial space under X-ray surveillance. All cases were followed up for 3-6 months after surgery, and no complications occurred.3. The main problem of laparoscopic removal of foreign bodies from the abdominal cavity is to quickly and accurately find the exact location of the foreign body and its relationship with the surrounding tissues, and among the 14 cases of foreign bodies in this group, 12 cases were found to have local damage and different degrees of adhesions caused. The damage caused by the foreign body when it entered the abdominal cavity or the local reaction between the foreign body and the surrounding tissues (such as the surgical gauze in this group), and the mutual adhesions between the tissues caused by the foreign body, were the most important ways to find the foreign body after placement of the laparoscope according to the medical history. Foreign bodies that are not fixed in the abdominal cavity are usually more difficult to detect, and although detailed preoperative examination and localization are performed, the location of foreign bodies can change with intestinal peristalsis and changes in body position due to the large intra-abdominal space, and even if they are accurately localized before going on the operating table, changes in location may occur intraoperatively [1]. In particular, smaller foreign bodies (such as the broken ultrasound tip in this group), which are wrapped in the greater omentum or hidden in the intestinal space, are difficult to detect because the local tissue reaction is small or has not yet formed an adhesive wrapping, and intraoperative real-time operation using a C-arm machine under X-ray and laparoscopy may help us to detect foreign bodies. In one case in our group, the ectopic birth control ring was removed by combining the two and finding the adhesions in the greater omentum. However, the X-ray display presented only a flat image of the bone and metal foreign body, which could not show the exact relationship between the foreign body in the abdominal cavity and the intestinal canal and large omentum. When turning the intestinal canal or large omentum, the foreign body moved with the movement of the intestinal canal and large omentum, and the laparoscopic instruments lacked the fine tactile function of the operator. In the other 2 cases in this group, the foreign body was not found through the laparoscope even under real-time X-ray surveillance, and the abdomen was opened in the middle, and after entering the abdomen In the other two cases, the foreign body was not found by laparoscopy under real-time X-ray surveillance, and the foreign body was still not accurately identified after the abdomen was opened, and the ultrasound tip hidden in the intestinal space and the metal ring wrapped in the greater omentum were only found by careful touch under X-ray. Intraoperative experience According to the relationship between the foreign body and the surrounding tissues, careful operation, foreign body fixed in the uterine wall, first carefully cut open the wrapped plasma membrane or adherent tissues with scissors, free the foreign body to expose it, grasp the forceps to remove it, and suture the rupture on the uterus; if the foreign body is wrapped in the greater omentum, part of the omentum can be excised and removed together with the foreign body without necessarily excessive freeing; acute or subacute inflammation of the tissues caused by the leftover surgical gauze stage with severe edema, blunt separation using the laparoscopic suction head to expose the foreign body can avoid injury. If the adhesions are tight and difficult to separate, or if the foreign body is embedded in the intestinal canal, bladder and other organs, and if the foreign body is too small and difficult to find, the abdomen should be opened in time, rather than forcing laparoscopic removal to avoid more damage; if the metal free foreign body in the abdomen cannot be found in a short time under X-rays, the abdomen should also be opened in time to avoid excessive prolongation of the operation.