UNC aims to leave no sponges behind

Anywhere between one in 100  to one in 5,000 patients nationally end up with a surgical tool left inside the body, with the most common being sponges.

Laparotomy sponges are used to control bleeding and help surgeons see structures inside the body. Scrub nurses count them to make sure none are left inside the patient, however, at times they can be hard to find. 

Dr. Christopher Rupp, a gastrointestinal surgeon at UNC Hospitals, said the sponges cause chronic pain, bowel obstructions and, in some cases, life-threatening infections. Patients also have to undergo another surgery to remove the sponge, and they sometimes file malpractice suits.

Rupp led the study at UNC testing a new system called RF Assure, which is designed to make sure no sponges get left behind.

"There's a small device in here that's almost the size of a little pill or twice the size of a kernel of rice," he said. "The device emits a radio frequency signal that is detected by a simple wand before incisions are closed."

Rupp said the device is strong enough to be detected through multiple, different layers.

Registered nurse Stella Nelson, the project manager of the study, said the sponges can be hard to find after a procedure. 

"If you imagine this as wet and getting shrunken down and then tucked behind an organ," she said. "It creates a problem for the patient."

While not removing a sponge is often associated with larger incisions, it can also happen in laparoscopic surgery. Nurses generally count the sponges carefully, but it sill happens. 

UNC Hospitals is the first in the Triangle to adopt the system, but Nelson predicts the RF Assure system or others like it will become the standard of care. 

"This is important," Nelson said. "It is an important adjunct to the manual counting that we have always done."