We report the successful removal of a shoulder fixation pin from the right lobe of the liver with intracorporeal repair of a diaphragmatic laceration. An expeditious workup and urgent operative intervention were required. We adhered to the principles of room setup, optical correctness, establishment of the triangle of success, appropriate instrument entry and convergence angles, two-handed surgical skills, and competence in intracorporeal suturing techniques that were all required for successful completion of the case. We also present a review of the significant literature.