Oh, My Gauze !!!- A rare case report of Laparoscopic removal of an incidentally discovered Gossypiboma during Laparoscopic Cholecystectomy

2020 
INTRODUCTION The work has been reported in line with the SCARE criteria. The most common retained foreign body during surgery is woven cotton surgical sponge, which includes both laparotomy pads and smaller sponges. Sponges are easily retained because of their ubiquitous use, relatively small size and when soaked in blood, sponges conform to and can be difficult to distinguish from surrounding tissues. The problem of retained surgical sponge is known as gossypiboma, and also as 'textiloma', 'gauzoma' or 'muslinoma'. The number of preoperatively diagnosed cases treated by laparoscopic approach is rare in the literature and laparoscopic removal of incidentally detected gossypiboma with concomitant laparoscopic cholecystectomy is not yet reported in the literature. PRESENTATION OF CASE In 40-year-old female with caesarean section 5 years ago, now during elective laparoscopic cholecystectomy and umbilical hernia repair, an incidentally detected Gossypiboma was encountered. The Gossypiboma was safely excised by laparoscopic technique followed by laparoscopic cholecystectomy and open hernia repair. DISCUSSION Postoperative complications following surgery are common and mostly unavoidable but some like the gossypiboma are infrequent and avoidable. Most of them are asymptomatic and present in the body for a long period of time. However, once discovered these foreign bodies must be removed for which laparoscopy proves to be a better approach. Most of these cases also are under-reported due to medicolegal implications. CONCLUSION Gossypiboma is one of the preventable complications of surgery by the compliance of certain measures perioperatively. If detected incidentally, it can be safely managed laparoscopically with a shorter post-operative hospital stay and better cosmetic results.
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