Gossypiboma - Successful retrieval through laparoscopy: A case report

INTRODUCTION: Numerous complications can occur after a surgery, but gossypiboma is undoubtedly the most unwanted and undesirable complication of a procedure for any surgeon with legal implications. Once suspected, the minimally invasive surgical approach should be considered for its management. PRESENTATION OF CASE: An adult P(1)L(1)E(1) female presented to the surgery OPD with a painless abdominal mass which progressively increased in size in the past 4 months. She underwent emergency surgery for a ruptured ectopic pregnancy 6 months back at some other health centre. On computed tomography scan of the abdomen, a well-defined heterogenous cystic lesion of size 9.8 cm × 9.2 cm × 7 cm was noted intraperitoneally. Few air foci with a hyperdense tubular structure within the lesion were seen, suggestive of a retained surgical sponge with its radio-opaque marker also visualised. The retained sponge was successfully retrieved by the laparoscopic approach. DISCUSSION: Traditionally, the open approach for the removal of the sponge was more accepted compared to the laparoscopic approach. This was due to the belief that intense foreign body reaction and dense adhesions around the sponge may make the laparoscopic approach difficult. However, laparoscopy can prove to be beneficial with its advantages of early ambulation, reduced post-op pain, cosmetically improved results and shorter length of hospital stay. CONCLUSION: All precautions must be taken to avoid retention of surgical sponge post-surgery. Case reports in which laparoscopy is used to retrieve gossypiboma are rare. The authors recommend the use of laparoscopy as a therapeutic option in the event of such mishaps.