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ed using bar codes," says Dr. Regenbogen. But it's just one component, he points
out: "Unfortunately, it doesn't prevent us from leaving some other instrument in."
Beyond the bar code
Your count is off, and you think your worst fears may be coming true. You may
have closed the incision with some sort of object still inside the patient. Now what?
"According to the literature, you find missing sponges about half the time on X-
rays," says Theodore Marentis, MD, MSEE, a radiologist at Dignity Health in
Sacramento, Calif. "With our computer-aided (Kalyspo) system, we've had 5 radiol-
ogists look at hundreds of images (using cadavers) and they find sponges 99.3% of
time. In other words, basically always."
The Kalyspo system (osmag.net/qgtx2d) — invented by Dr. Marentis — is a
computer-aided detection system that's expected to be commercially available in
the next year or two. It relies on proprietary software and a tag that's about the size
of a baby aspirin. The tag is designed to maintain its shape and stay clearly visible
on X-rays, no matter what contortions or shapes the missing item assumes, or how
well concealed it is. Initially developed in the University of Michigan radiology and
mechanical engineering departments, the software, says Dr. Marentis, will also help
detect items that are too small to tag.
The system, which would add about $30 in costs to a typical case, is likely to con-
vey its greatest value both when objects are unaccounted for, and in what are
known to be high-risk cases for smaller objects to be left behind. Those, he says,
include patients with higher BMIs, cases that last longer than 4 hours and involve 2
surgical teams, and trauma cases.
The idea is to augment barcode scanning and counting with X-rays that provide
much more reliable detection, when needed. Dr. Marentis calls it a "fail-safe"
approach. "It's like an airbag," he says. "What we're using now is an airbag that
deploys only half the time."
OSM