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Objective: The aim of this study is to reproduce successfully the principle of a pediatric surgical operation in a complicated adult patient. Summary Background Data: Mesh rectopexy is a known operation, infection in mesh is an unknown complication but it happens. Several techniques had been reported in journals. Our challenging case where the residual mesh migrated down and the patient was treated with total proctectomy and endo-anal pull-through procedure. So far literature review suggests this is the first case of this kind. Methods: This patient was operated after reviewing the situation and following the pediatric surgical principle. Results: We have operated the patient successfully and patient has recovered well. Conclusions: Our patient was a unique complicated patient and we had applied pediatric surgical principle successfully.