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Unfortunately, despite efforts to ensure that operating rooms in the United States are safe, approximately a dozen sponges and surgical instruments are left behind inside of patients’ bodies each day. As the American Society of Anesthesiologists has concluded, this amounts to anywhere between 4,500 and 6,000 cases of retained surgical instruments each year. According to CNN, there is no federal reporting requirement in the US for these types of cases, so determining the exact number is not easy. A 2003 New England Journal of Medicine study determined that approximately 70% of the retained items are sponges. Other items that may be left behind are clamps and retractors. Sometimes items may be left behind for years before they are discovered, causing significant complications and painful symptoms.
Why does it happen?
Surgical instruments may be left behind during operations for many reasons. Emergency surgeries, distractions during procedures, changes during surgeries and high stress situations are more likely to result in retained items.
What kind of complications can RSI cause?
Retained surgical instruments can cause complications, especially when they are left for long periods of time. The body may form scar tissue and adhesions around the item, resulting in pain. Depending on where the item is left, gastrointestinal issues may arise, as well as infection. There have been cases in which patients have died due to infections caused by RSI.
Preventing RSI
Many studies and programs have addressed ways to prevent retained surgical instruments. Most Japanese hospitals require that imaging be performed before closure of a surgical wound, particularly during abdominal procedures. The American Association of Operating Room Nurses has recommended that sponge and instrument counts be performed at least five times during surgeries. Some hospitals use automated counting via sponges that have bar codes on them. Technology, such as radiofrequency-sensitive materials, helps to ensure that these items can be picked up on x-rays.
