ABSTRACT.Gossypiboma is not an uncommon surgical complication but it is rarely reported mainly due to medico-legal problems. A case of a surgical sponge left in the peritoneal cavity at caesarean section eroded into the bowel and caused intestinal obstruction one year later is presented. She was treated with small bowel resection. Small bowel wall opened by enterotomy and sponge removed. A report of a correct sponge count in the operating room does not exclude the possibility of a retained surgical sponge. Certainly it is the responsibility of the surgeon to make sure that he did not leave any sponge behind. This issue will be discussed in this paper. The English literature was reviewed.
Seventy-three patients who had incisional hernia repair at two hospitals, a government and a private, from 2000 to 2005 were reviewed. Fifty-nine (80.8%) patients were females and 52 (71.2%) patients were Saudi. Five (6.8%) patients had minor complications. Twenty-four (32.9%) patients had polypropylene mesh while 49 (67.1%) patients had vypro mesh, both types where fixed intraperitoneally using absorbable vicryl 2/0 interrupted suture. No differences in complications, duration of surgery, or hospital stay between patients using either vypro or prolene mesh. Intraperitoneal mesh placement of incisional hernia is safe on short and long term follow-up. Vypro mesh compares favorably with prolene mesh. The authors encountered no enterocutaneous fistula and experienced only 2 (2.7%) recurrences over one year.
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