Patient Safety in Surgery (Sep 2019)

Unintended retention of a ruptured radiopaque thread extending from the corner of a gauze during laparoscopy

  • Yoshiaki Oshima,
  • Osamu Yamamoto,
  • Akihiro Otsuki,
  • Saori Tokunaga,
  • Keiichiro Ueda,
  • Yoshimi Inagaki

DOI
https://doi.org/10.1186/s13037-019-0209-1
Journal volume & issue
Vol. 13, no. 1
pp. 1 – 3

Abstract

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Abstract Small gauze is used in laparoscopy; therefore, retention of gauze can occur. We experienced a case of retention of a radiopaque thread that ruptured from a piece of gauze and moved into the peritoneum during a scheduled laparoscopy. The patient was a 65-year-old woman who underwent laparoscopic-assisted transverse colon resection for transverse colon cancer. A commercial gauze commonly used for laparoscopy was used during the surgery. To more easily identify the gauze during surgery, radiopaque threads extending up to 3.0 cm from the two diagonal corners of the gauze body were attached. After wound closure, radiography showed a radiopaque thread-like substance in the abdomen. Minor laparotomy was performed, and part of the radiopaque thread was discovered. On postoperative day 22, the patient was in remission and discharged.

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