Retained needles in laparoscopic surgery: open or observe?

Area of Science:

• Surgical Procedures
• Patient Safety
• Medical Device Management

Background:

• Laparoscopic surgery lacks a standardized protocol for managing retained foreign bodies (RFBs).
• Uncertainty exists regarding the optimal approach to RFBs of unknown injury potential during minimally invasive procedures.

Purpose of the Study:

• To assess current clinical practices and attitudes towards managing retained needles or foreign bodies (RFBs) in laparoscopic surgery.
• To understand surgeon decision-making processes when faced with intraoperative RFBs.

Main Methods:

• A survey was distributed to assess surgeon experience and opinions on RFB management.
• The survey included 18 questions covering clinical practices, attitudes, and responses to a specific case scenario.

Main Results:

• Responses indicated a split in management strategies: 45.8% would convert to open surgery, 26.5% would leave the RFB intraperitoneally, and 27.7% would consult the patient/family.
• When patient/family consultation was removed as an option, 54.5% opted for conversion to open surgery, while 45.5% would leave the RFB.
• A significant majority (92.6%) believed RFBs pose future risks, yet 89.4% considered laparotomy a greater risk than the RFB itself.

Conclusions:

• There is no established best practice for managing retained foreign bodies of uncertain injury potential in laparoscopic surgery.
• Surgeon opinions are divided on the best course of action, reflecting a need for clearer guidelines and further research.