Gossypiboma

Gossypiboma, textiloma or more broadly Retained Foreign Object (RFO) is the technical term for surgical complications resulting from foreign materials, such as a surgical sponge, accidentally left inside a patient's body. The term 'gossypiboma' is derived from the Latin gossypium (“cotton wool, cotton”) and the suffix -oma, meaning a tumor or growth, and describes a mass within a patient's body comprising a cotton matrix surrounded by a foreign body granuloma. 'Textiloma' is derived from textile (surgical sponges have historically been made of cloth), and is used in place of gossypiboma due to the increasing use of synthetic materials in place of cotton.The actual incidence of gossypiboma is difficult to determine, possibly due to a reluctance to report occurrences arising from fear of legal repercussions, but retained surgical sponges is reported to occur once in every 3000 to 5000 abdominal operations and are most frequently discovered in the abdomen. The incidence of retained foreign bodies following surgery has a reported rate of 0.01% to 0.001%, of which gossypibomas make up 80% of cases.To prevent gossypiboma, sponges are counted by hand before and after surgeries. This method was codified into recommended guidelines in the 1970s by the Association of periOperative Registered Nurses (AORN). Four separate counts are recommended: the first when instruments and sponges are first unpackaged and set up, a second before the beginning of the surgical procedure, a third as closure begins, and a final count during final skin closure. Other guidelines have been promoted by the American College of Surgeons and the Joint Commission.