Abstract
Background
Retained surgical items (RSIs) represent a significant patient safety concern in minimally invasive surgery (MIS) due to the limitations of conventional detection methods. This study evaluated the technical feasibility of a novel triple-detector radiofrequency identification (RFID) system integrated into a laparoscopic port for automated, real-time tracking and directional differentiation of surgical gauze during procedures.
Methods
We developed a prototype system integrating three RFID detectors (134.2 kHz) longitudinally into a standard 12-mm laparoscopic port. In a controlled laboratory setting, 118 pieces of RFID-tagged gauze were systematically inserted and retrieved through the port, generating 236 events. The study evaluated detection accuracy across outer, middle, and inner channels, alongside directional discrimination capability and temporal tracking performance using a laparoscopic training model.
Results
Detection rates exceeded 99% across all three channels (99.58% for the outer channel and 99.15% for middle and inner channels). Directional differentiation accuracy, based on sequential detection patterns, was 94.92% for insertion and 95.76% for removal. Anomalous patterns (4-5%), such as channel omission or duplicate detection, were observed due to passage speed or angle, but they did not impact the final determination of gauze presence or absence.
Conclusions
This proof-of-concept study demonstrates that an RFID-integrated laparoscopic port can achieve high detection (>99%) and directional accuracy (∼95%). These findings support its technical feasibility as an automated safety mechanism for potentially reducing the risk of RSIs in laparoscopic surgery; however, further validation through animal studies and clinical trials is required to confirm these results.
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