Retained Surgical Foreign Bodies: A Comprehensive Review of Risks and Preventive Strategies

Abstract

Given the increasing complexity of both the modern health care environment and the overall patient population, reduction of medical errors is a high priority task for health policy makers and medical/surgical community alike. The problem of retained surgical foreign bodies (RSFB) has existed ever since the humans first performed surgical procedures. Retained surgical foreign bodies continue to be a significant problem with an incidence between 0.3 and 1.0 per 1,000 abdominal operations. Retained surgical foreign bodies have the potential to cause harm to the patient and carry profound professional and medico-legal consequences to surgical trainees, surgical practitioners, hospitals, and health systems. Currently, there are no known methods of entirely eliminating the occurrence of RSFB. In this manuscript, the authors discuss the available evidence with regards to risk factors associated with RSFB as well as methods of minimizing the incidence of RSFB. Modern technological advances designed to decrease the incidence of RSFB (radio-frequency tagging of surgical sponges) and improved perioperative patient processing (multiple 'checks and balances' and better provider-to-provider communication) are reviewed. The authors also explore the relationship between RSFB and surgical training with emphasis on education in early recognition, prevention, and focus on team-oriented training strategies.

Possible impact of continuous drainage after minimally invasive partial nephrectomy

“…However, many surgeons still assume that drain placement after MIPN is necessary in order to drain urinary leakage and treat postoperative bleeding. In addition, several reports have been published about drain-related complications such as infection, retained drain fragments, and discomfort [4,5].…”

Approach of forensic medicine to gossypiboma

“…In the review of articles published in the literature, Stawicki et al (8) stated that appropriate and accurate counting of sponges is the primary requirement in reducing these cases. However, how sponge counts are performed is also important.…”

Gossypiboma of the Abdomen and Pelvis; A Recurring Error

“…Radiological investigations have high diagnostic value and comprise ultrasonography, plain abdominal radiography and computerized tomography scanning (7,10). Gossypiboma may be prevented by counting sponges before and after surgery, use of sponges with radiopaque markers, tagging sponges and compresses used in the abdomen, adequate examination of the operative field and radiography of the abdomen before wound closure if required (1,(10)(11)(12). Retained sponges still occur despite a presumed correct swab count (3).…”