A protocol to recover needles lost during minimally invasive surgery

Area of Science:

• Surgical Safety
• Minimally Invasive Surgery
• Medical Device Management

Background:

• Retained surgical needles pose risks like chronic pain and organ injury.
• Minimally invasive surgery presents unique challenges for needle retrieval due to size and limited visualization.
• Existing protocols for lost needle recovery are scarce.

Purpose of the Study:

• To investigate the incidence of lost surgical needles in minimally invasive procedures.
• To identify effective techniques for surgical needle recovery.
• To develop an evidence-based protocol for expedited needle retrieval.

Main Methods:

• A survey was distributed to 305 minimally invasive surgeons across the US.
• Surgeons reported on needle loss incidence and recovery strategies.
• Survey data informed the creation of a new recovery protocol.

Main Results:

• 64% of surgeons reported losing surgical needles, with 112 lost in the past year.
• Urology, pediatric, and bariatric surgery subspecialties reported higher incidence.
• Common loss scenarios include needle removal via port and laparoscopic suturing.

Conclusions:

• A protocol integrating camera surveys, fluoroscopy, port inspection, and systematic visual search is proposed.
• This protocol aims to expedite the recovery of lost needles in minimally invasive surgery.
• The findings highlight the need for standardized procedures for managing retained surgical instruments.