Chronic pelvic pain affects up to 24% of women and accounts for 20% of gynecological clinic referrals. Common causes of chronic pelvic pain include adenomyosis, chronic pelvic inflammatory disease and endometriosis which is observed in up to 87% of cases.

Maibotsu-shin acupuncture is a unique technique that uses permanent needles, which may pose diagnostic challenges and cause complications, such as perforation of viscera, localized argyria, gold-induced toxicity. This video presents a case of incidentally found acupuncture needles in uterosacral ligaments at the time of laparoscopic endometriosis resection and present radiologic and intraoperative findings

Design:

This video uses images, video footage and narration to review chronic pelvic pain, endometriosis, Maibotsu-Shin acupuncture and presents a unique case of an incidental finding of permanent acupuncture needles in uterosacral ligaments.

Setting:

Tertiaty Hospital, minimally invasive gynecologic surgery operating room

Patients or Participants:

28-year-old patient with a history of chronic pelvic pain undergoing laser-assisted laparoscopic endometriosis resection.

Interventions: Laser-assisted laparoscopic endometriosis resection

Measurements and Main Results:

Endometriosis management includes analgesia, hormonal suppression and surgical excision. Laparoscopic resection is the preferred surgical approach. Our patient underwent laser-assisted laparoscopic endometriosis resection. During the procedure, numerous acupuncture needles were removed from bilateral uterosacral ligaments.

Conclusion:

Permanent needle acupuncture is a rare and unusual technique. In our patient, the finding of gold needles was incidental. Permanent needle acupuncture may pose diagnostic challenges and medical professionals should be familiar with possible imaging findings and complications.