To forget is human: the case of the retained bulb

Abstract

The scenario of a forgotten instrument or foreign body has plagued surgical procedures from the early days. It has been estimated that the incidence of retained foreign bodies is around one in every 1,000-1,500 intra-abdominal operations and can be expected to occur at least once per year in hospitals where 8,000-18,000 major surgeries are performed annually. We report a case of a forgotten asepto bulb in the vagina following a robot-assisted total laparoscopic hysterectomy.

Clinical Issues‐January 2016

“…The physician admitted the patient, used CT guidance to drain the abscess, and treated the patient with IV antibiotics before discharging her the next day. She recovered with no further complications 4 . These cases demonstrate the potential for cervical cups and bulb syringes to become retained surgical items and support the counting of these items during robot‐assisted laparoscopic gynecological procedures.…”

“…Sakhel and Hines 4 also reported a case of a retained bulb syringe. During a robot‐assisted total laparoscopic hysterectomy on a 34‐year‐old woman, the surgeon intentionally detached a bulb from its syringe and placed it in the patient's vagina to maintain pneumoperitoneum during the closure of the vaginal cuff.…”

“…Two case reports demonstrate the potential for bulb syringes to be retained during robot‐assisted gynecological procedures when the surgeon uses a bulb syringe to maintain pneumoperitoneum during the laparoscopic closure of the vaginal cuff 3,4 . Toubia and Sangha 3 described the case of a 33‐year‐old woman who underwent a robot‐assisted total laparoscopic hysterectomy with bilateral salpingo‐oophorectomy, appendectomy, and cystoscopy.…”

Patient safety risk assessment and risk management: A review on Indian hospitals

“…[16] Common instruments are needles, knife blades, safety pins, scalpels, clamps, scissors, sponges, towels, and electrosurgical adapters. Also retained are tweezers, forceps, suction tips and tubes, scopes, ultrasound tissue disruptors, asepto bulbs, [17] cryotomes and cutting laser guides, and measuring devices. The single most common left behind object is a sponge.…”

“…[17] The major reason for this is our economy which spends less than 2% of its Gross Domestic Product on health. That turns out bright young doctors and looks after a workload of patients with a spectrum of diseases far broader than found in the private sector, yet are at times the unfair target of criticism during healthcare crises.…”