Project Description:

Retained surgical items (RSIs) are serious, preventable complications where an object is unintentionally left in a patient after surgery, with rates as high as 1 in 300 surgeries in low- and middle-income countries (LMICs). Sponges and gauzes are the most commonly retained and clinically dangerous items, often leading to infection, prolonged hospitalization, and additional surgeries. The absence of affordable intraoperative imaging in LMICs forces surgical teams to rely solely on manual counting, which is inconsistent and error prone. Sponsored by Emory faculty and in collaboration with surgical partners in Ecuador, our team developed RECUVERY: a low-cost, dual-layer system designed specifically to support clinicians in preventing and identifying RSIs in resource-constrained operating rooms. At the core of the system is UV fluorescence. Sponges and gauzes are embedded with biocompatible UV-reactive threads that fluoresce under UV light, enabling surgical teams to rapidly locate missing materials when counts are incorrect. This allows staff to identify misplaced items before closure, preventing complications without adding time, cost, or complexity to the procedure. To further streamline organization and reduce cognitive burden, RECUVERY incorporates the SurgiRack, a magnetic pole that visually displays soft surgical items as they are used. With the SurgiClip, a magnet is attached to each item and is hung immediately after use. This gives scrub technologists and circulating nurses a clear, complementary visual reference that supports manual counting and reduces workflow interruptions. RECUVERY has been verified to be biocompatible with animal blood and demonstrated effectiveness in simulated operative settings that mirror real LMIC workflows. By enabling a more reliable and streamlined approach to RSI prevention, RECUVERY reduces patient harm, shortens operative delays, and lowers the financial burden on hospitals. Ultimately, RSIs are “never events,” so we are designing technology to ensure they truly never happen.