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Needle in a haystack: Intraoperative breakage of pediatric minimal access surgery instruments
S V Parelkar1, B V Sanghvi, S R Shetty
1Department of Pediatric Surgery, King Edward Memorial Hospital, Mumbai, Maharashtra, India.
Abstract:
The search for tiny bits of broken pediatric minimal access surgery (MAS) instruments in an operative field is akin to the search for a needle in a haystack. With the extension of MAS to the pediatric age group, instruments are becoming smaller and equitably more prone to breakage. When breakages occur, retrieval, especially in the pediatric abdominal cavity, can be challenging. Inability to do so would affect patient safety and also lead to a web of medico legal and ethical issues. We present two cases of intraoperative breakage: An eyeless 3-0 polyamide suture needle and a 2-mm grasper blade both of which were successfully retrieved and fortuitously escaped becoming retained surgical items.
Insights
Pediatric minimal access surgery (MAS) instruments can break, posing retrieval challenges. This study highlights successful retrieval of broken pediatric surgical tools, preventing retained surgical items and ensuring patient safety.
Area of Science:
- Pediatric Surgery
- Surgical Instrumentation
- Patient Safety
Background:
- Minimal Access Surgery (MAS) is increasingly used in pediatric patients.
- Smaller pediatric surgical instruments are more susceptible to intraoperative breakage.
- Retained surgical items pose significant risks to patient safety and can lead to medico-legal issues.
Observation:
- Two cases of intraoperative instrument breakage during pediatric MAS are presented.
- Case 1 involved a broken eyeless 3-0 polyamide suture needle.
- Case 2 involved a fractured 2-mm grasper blade.
Findings:
- Both broken surgical instruments were successfully retrieved from the pediatric operative field.
- The retrieval prevented the instruments from becoming retained surgical items.
- Prompt identification and retrieval are crucial for mitigating risks associated with broken instruments.
Implications:
- Successful retrieval protocols are vital for enhancing patient safety in pediatric MAS.
- Effective management of intraoperative breakages minimizes medico-legal and ethical concerns.
- This highlights the need for vigilance and specialized techniques in pediatric surgical instrument retrieval.
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