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Related Concept Videos

Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...

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Related Experiment Video

Updated: May 18, 2026

Intraoperative Strategy under Complex Vascular Adhesion for Laparoscopic Radical Resection of Bismuth-Corlette Type IIIb Perihilar Cholangiocarcinoma
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Retained surgical items: a problem yet to be solved.

Stanislaw P A Stawicki1, Susan D Moffatt-Bruce, Hesham M Ahmed

  • 1Department of Surgery, The Ohio State University College of Medicine, Columbus, OH 43210, USA. stanislaw.stawicki@osumc.edu

Journal of the American College of Surgeons
|October 9, 2012
PubMed
Summary
This summary is machine-generated.

Retained surgical items (RSIs) are linked to longer surgeries, safety variances, and incorrect counts. Trainee presence may reduce RSI risk, warranting further investigation into this protective effect.

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Area of Science:

  • Medical Safety
  • Surgical Outcomes
  • Risk Factor Analysis

Background:

  • Retained surgical items (RSI) remain a significant concern in healthcare, with limited large-scale studies defining their risks due to low incidence and medicolegal issues.
  • Existing research shows discrepancies in identified risk factors for retained surgical items, necessitating further investigation to clarify these associations.
  • Potential contributors to retained surgical items, such as the presence of trainees, require evaluation to fully understand their impact on patient safety.

Purpose of the Study:

  • To comprehensively define risk factors associated with retained surgical items (RSI).
  • To clarify previously discrepant findings regarding retained surgical item risk factors.
  • To evaluate the influence of factors like trainee presence on the occurrence of retained surgical items.

Main Methods:

  • A multicenter case-match study was conducted from January 2003 to December 2009.
  • Retained surgical item (RSI) cases were identified through clinical quality improvement and adverse event reporting.
  • Risk factors were analyzed using univariate and multivariate conditional logistic regression, comparing RSI cases with matched non-RSI controls.

Main Results:

  • Analysis of 59 retained surgical items (RSIs) and 118 controls revealed an incidence of 1 in 6,975 procedures.
  • Retained surgical items occurred even with advanced measures like confirmatory X-rays and radiofrequency tagging.
  • Confirmed risk factors for increased RSI risk include higher body mass index, unexpected intraoperative events, longer procedure duration, any safety variance, and incorrect counts during surgery.
  • Notably, trainee presence was associated with a 70% reduced risk of retained surgical items compared to their absence.

Conclusions:

  • Longer surgical duration, safety variances, and incorrect counts are confirmed as significant risk factors for retained surgical items (RSI).
  • The potential protective effect of trainee presence warrants further in-depth study.
  • Emphasizes the need for zero tolerance for safety omissions, development of novel RSI reduction strategies, and anonymous reporting systems to improve tracking and prevention.