M.B. de Kleine
Technische assistentie voor optimalisatie telprocedure bij operaties
Report 2005.TL.7016, Transport Engineering and Logistics.
During medical surgery several sponges are being used. Before closure of
the wound all sponges must have been removed. Not removing all the sponges
can result in physical complaints and possibly a decline in the patient's
health. To ensure that no sponges have been left behind, a counting
procedure is being used during surgery. If there is any doubt about the
presence of sponges in the patient's body, an X-ray photo is taken.
Possibly, the chance of a sponge being left behind in the patient's body
can be reduced using modern day technology. Using two main questions, an
analysis of the possibilities has been made. The first main question is
whether the counting procedure can be improved using modern day
technology. The second main question is which possibilities, besides
X-ray, are available to detect sponges in the human body.
Both main questions are based on the same question; how can an object be
detected? The principles of detecting have been analysed and categories
have been formulated. Highly used detection methods (e.g. Radio Frequency
Identification (RFID) and MRI) have been examined. A number of patents have
also been examined.
During this research it appeared that for many years people have tried to
reduce the probability of a sponge being left behind. Many patents have
been claimed, but none of the patents has led to a reliable and beneficial
solution. The current counting procedure has a high reliability. A
technical assisting system has to be very reliable in order to be able to
assist during the counting procedure.
The detection methods that have been analysed showed a limited level of
reliability. Costs are also an issue. Because the current counting procedure
is functioning at a high level, a new system has to be affordable besides
being very reliable.
Of all detection methods that have been discussed, RFID is most suitable
for assisting in the counting procedure. Other methods mainly focus at
sponge detection in the human body. Still, the scan range and reliability
of RFID are not adequate enough for the system to be of any support during
the counting procedure. Also, RFID is still too costly. The costs of the
tags will decrease over time, especially when large amount of tags are
It can be concluded that RFID can not be of any support during the counting
procedure, but may become so in the near future if the scan range and
reliability increase while the costs decrease. Because the current
counting procedure is functioning at a high level, it is hard to make an
improvement in this counting procedure. More interesting is how the
detection of sponges in the human body can be improved. This can be done
by increasing the radiopacity of the sponges when using X-ray. Further
research on how the radiopacity can be increased is needed.
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