The Impact of Retained Surgical Items on Patient and Clinical Practice: A Systematic Review

Retained surgical items (RSIs) are foreign objects left inside after surgery, classified as serious but preventable never events. This review aims to examine the consequences and impact of RSIs, thereby raising awareness and emphasizing prevention. The author reviewed case reports published between 2020 and 2024. A total of 37 cases were evaluated. Excluding 3 asymptomatic patients, 91.89% sought medical help due to discomfort, with 59.46% experiencing pain. On average, 2.33 additional imaging examinations were required. Of the patients, 94.59% underwent a second or more operations, 77.14% of which were open surgeries. Serious complications were observed in 29.73% of cases, and 3 patients died from complications. The average stay to discharge after surgery was 5.94 days. The median incubation time was 1.75 years. RSIs were found across various procedures and anatomic sites, with 67.57% presenting nonspecific symptoms. Only 32.43% of diagnoses were identified through imaging, and 70.27% were confirmed intraoperatively, indicating that the primary diagnosis matched the final diagnosis in only 29.73% of cases. The impact of retained surgical items on patients and health care providers is significant. Prevention is always better than cure.