Laparoscopic retrieval of gossypibomas--short series and review of literature.
Laparoscopic removal of retained abdominal foreign bodies represents an obscure domain of minimally invasive surgery. Although not an infrequent situation in general surgical practice, there are very few papers presenting laparoscopic approache in these circumstances. An iatrogenic foreign body following surgery, is a serious complication that may lead to medico-legal problem. We present our experience and a literature review.


METHODS
In the last 20 years 48 patients with abdominal foreign bodies were referred to us. Out of these four gossypibomas were managed laparoscopically.


RESULTS
Retained swabs represent the most common iatrogenic abdominal foreign bodies. Removal of gossypiboma present more problems in laparoscopic environment due to encapsulation and difficulties in localisation, as retained swabs unusually display radio-opaque markings. There was one conversion due to dense adhesion to the gastric wall. Postoperative recovery was uneventful in all cases.


CONCLUSIONS
Gossypibomas, among abdominal foreign bodies, represent a certain reality with significant legal implications. Prevention should prevail and all efforts should be made in such respect. Laparoscopic approach is possible in selected cases (small swabs, encapsulated, no complications).
University of Medicine and Pharmacy "Gr. T. Popa" Iaşi, University Hospital "Sf. Spiridon" Iaşi, Romania. etarco@iasi.mednet.ro
E
E
Târcoveanu
G
G
Dimofte
St
S
Georgescu
A
A
Vasilescu
C
C
Lupaşcu
C
C
Bradea
R
R
Van Hee
D034841:Abdominal Cavity; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D005547:Foreign Bodies / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D019300:Medical Errors / Q000517:prevention & control; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D015503:Surgical Sponges; D016896:Treatment Outcome