During the American College of Surgeons annual Clinical Congress and Exposition held last week in Washington, D.C., the results of a study funded by RF Surgical Systems offered some interesting findings related to the use of radio frequency technology and how it can help prevent sponges from being left in the body after surgery.

As stated in the report, “This large, prospective, multi-institutional study was designed to understand the current process instituted to minimize the risk of RFOs (retained foreign objects); determine the incidence of incorrect counts and RFOs; identify the potential risk factors associated with RFOs; and to evaluate radio-frequency surgical technology in preventing these sentinel events and impacting on intra-operative efficiency and nurse confidence.”

The prospective, multi-institutional, IRB-approved study utilized:

  • RF Detection System from RF Surgical Systems.
  • Specially tagged laparotomy pads/raytec sponges.
  • Manual counting procedures.
  • Data pertaining to surgical procedure type and length, number of surgical teams, changes in nursing staff, daytime or evening surgery, x-ray use, blood loss, documentation of counts and miscounts, and the effectiveness, efficiency and ease of use of the RFDS.

A total of 1,663 complete patient data sets were recorded. In 1,641 cases the counts were reported as correct, however the RF Detection System still found one missing sponge off the surgical field. In 22 cases in which the counts were reported as incorrect, the RF Detection System detected eight missing sponges in patients, as well as eight missing sponges in drapes/the off-surgical field, and in two cases there were no sponges discovered or no RF detection (X-ray was used to resolve the discrepancy and no sponges were found). Overall, the RF Detection system had no false negatives.

Primary characteristics of the patients in which incorrect sponge counts were detected included:

  • Prominently male.
  • A larger BMI.
  • The procedures were four hours or longer.

Christopher Rupp, MD, Assistant Professor for Surgery and Co-Director, Center for Pancreatic and Biliary Diseases at the University of North Carolina School of Medicine, was the study’s principle investigator. “The RF Surgical system proved especially useful in longer operations where there was a lot of blood loss,” he stated. “In addition to ensuring a higher level of care, the system also allows OR time to be reduced, as the counts can be confirmed before ending the surgery.”

When nurses were asked for their thoughts on RF detection system use:

  • 94 percent said it improved confidence in the final count.
  • 89 percent felt it was not stressful to use.
  • 97.5 percent felt it was easy to use.

“Overall, the system seemed to be very well received by OR staff,” offers Rupp. “While there’s always going to be some initial resistance to a new technology or protocol, everyone can appreciate the increased reliability and the fact that once using the system became integrated into the flow of the operation, people did not need to give a lot of thought to using it.”

Conclusions for the study entailed:

  • The incidence of incorrect manual sponge counts (first or second attempt) is 1.4 percent.
  • RFOs can still occur, regardless of whether the manual counts were correct.
  • No false negatives occurred using the RF Detection System.
  • While the incidence of retained sponges is low, RF detection can expedite identification and void the use of radiation to locate missing sponges, thus improving safety and efficiency in the OR.

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