Words Surgeons Should Never Say: Did We Forget Anything?
The words patients never want their surgeon to utter while they are under anesthesia are “Did we forget anything?” That “anything” could be sponges, blades, retractors, needles, and other surgical implements used during the procedure, and inadvertently left behind in the body.
A new system helps prevent left-behind objects
Researchers at the University of Michigan Health System (UMHS) have developed a new system that can help ensure no foreign objects are left behind during surgical procedures. Although leaving sponges, retractors, and other items in the body after surgery is not a common occurrence, “It’s something that should never happen,” according to Ella Kazerooni, MD, MS professor of radiology at the U-M and associate chair of clinical affairs at the UMHS.
In a study reported at the 2010 Annual Clinical Congress of the American College of Surgeons in Washington, DC, researchers from the University of North Carolina Chapel Hill noted that their “preliminary data agrees with the previously reported incidence of retained surgical sponges.”
The incidence of left-behind surgical instruments in previous studies has varied from about one in 1,000 operations to one in 18,000. In the North Carolina study, the authors reported finding one sponge in one operation in 1,600.
At UMHS, several methods are being used to help prevent “lost” surgical instruments. For example:
Because sponges are the objects most often left behind, the sponges used by surgeons are bar coded. Sponges are scanned before use and after they are removed. If there is a discrepancy between the number of sponges put in and those taken out, the computer lets the surgical team know.
Typically, surgical room teams manually count sponges and other instruments during a procedure to help ensure no objects are left behind. This can be a tedious task, as Shawn Murphy, RN, nursing director of UMHS operating rooms explained: “Surgical teams may count more than a hundred items in a single case.”
An electronic radiology order system can be called immediately to help locate retained objects while the patient is still in the operating room. According to Kazerooni, once a surgical team realizes there may be a retained object in a patient, “there needs to be good communication with the radiology department to get the technologist into the OR as quickly as possible.” Expediency is critical to prevent delaying the surgery or prolonging the time a patient spends under anesthesia.
More than 234 million surgeries are performed each year around the world, with about 46,000 cases alone at UMHS. Therefore there are many opportunities for foreign objects to be left behind in patients.
Kazerooni noted that “The University of Michigan is leading the way in reducing retained foreign objects in the operating room.” Initiatives like those at UMHS can help reduce the chances that your surgeon will utter the words, “Did we forget anything?”
University of Michigan Health Systems
University of North Carolina School of Medicine (2010, Sept 30). No sponge left behind. ScienceDaily, Retrieved Feb 7, 2012
Image: Courtesy of Wikimedia Commons