V09-11: Needle in a haystack: Prevention and management of needle loss during robotic surgery

Video

INTRODUCTION

Loss of a surgical needle during surgery is an uncommon event. When it happens, it has implications that could be clinical as well as medico-legal. Minimally invasive surgery has brought in with it the advantages of magnification. Hence the possibility of using smaller needles. In event of loss of a needle , there is anxiety in the operating room . There is an increase in operating room time due to the time spent on retrieval of the needle. In this video we discuss strategies to prevent and manage needle loss during robotic surgery.

METHODS

We studied our database of Robotic surgical procedures between April 2016-April 2018. All adverse events and measures taken to rectify them are noted in the operative charts of the patients at the time of surgery. We attempted to develop a protocol to prevent as well as manage needle loss, based on our experience as well as review of existing literature

RESULTS

A total of 280 Robotic surgical procedures were carried out in the time period studied. There were 5 instances of needle loss (1.7%) . All needles that were found to be missing were retrieved successfully. Systematic search alone sufficed in 3 of the 5 cases, additional equipment was required in 2 cases ( Fluoroscopy and laparoscopic instruments in one case and Flexible cystoscope in another).

CONCLUSION

Needle loss is a potentially serious problem during robotic surgery. The best way to mange it is to prevent it. Once it occurs a systematic , protocol based team approach is necessary.

Funding: none