title: Intraoperative loss of a surgical needle: a laparoscopic dilemma.
abstract: BACKGROUND
  Increasing awareness around patient safety and efforts to reduce medical errors has become a priority in the modern health care system. Losing needles during laparoscopic procedures is an uncommon occurrence; however, it poses a significant dilemma for the operating surgeon because retrieval can be a major challenge even for highly skilled and experienced operators.
  
  
  OBJECTIVE
  The objective of this paper was to review the current literature and highlight this potentially serious issue and suggest a method of dealing with this uncommon occurrence.
  
  
  METHODS
  A comprehensive literature search was conducted using several Internet search engines including PubMed, Google Scholar, and ScienceDirect.
  
  
  CONCLUSIONS
  The risks associated with retained small foreign bodies remains unknown, and there are few reports and little consensus on how surgeons should manage retained needles or other small foreign bodies during laparoscopic surgery. We propose an algorithm that may be implemented as a standard operating procedure in surgical theatres when a surgeon is faced with such a dilemma.
authors.affiliation: Heart of England NHS Foundation Trust, Bordesley Green, Birmingham, UK.
authors.forename: Shafquat
authors.initials: S
authors.lastname: Zaman
authors.affiliation: Shrewsbury and Telford NHS Trust, Mytton Oak Road, Shrewsbury, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Clarke
authors.affiliation: Shrewsbury and Telford NHS Trust, Mytton Oak Road, Shrewsbury, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Schofield
mesh_terms: D000465:Algorithms; D020878:Device Removal; D005547:Foreign Bodies / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007431:Intraoperative Complications; D010535:Laparoscopy; D019300:Medical Errors; D009339:Needles; D011859:Radiography; D013536:Suture Techniques / Q000295:instrumentation*
keywords: Laparoscopy; Lost needles