A historical perspective on the problem of the retained surgical sponge: Have we really come that far?

Retained surgical items, particularly surgical sponges, are a considered a "never event." Unfortunately, they continued to be reported despite significant efforts to reduce them. Our goal was to identify some of the earliest reports of surgical items, particularly surgical sponges, to see how it was presented in the literature as well as any insights into contributing factors and processes to mitigate the event. We progress forward in time to look at how this issue has been addresses or changed as we enter the 21st century. After this review, it appears that our advances are not as significant as those efforts proposed over 100 years ago. We view this as a call to action for significant change in our operative safety processes and to incorporate available technology.

Otology through the ages.

Recounted are some, not all, of the most significant contributions to otology. The history of otology has, for the most part, followed the history of medicine: Little was known of otology by the ancient physicians, but their work must be reviewed to appreciate the progress that has been made. Most of the otology produced during the Middle Ages was limited to those structures that were readily accessible; otologic surgery was confined to trauma and removal of foreign bodies from the external auditory canals. Examination of the ear began after studies of the ear by Italian anatomists during the seventeenth century. It was not until the end of the eighteenth century that magnification was used so that the minute anatomic details could be observed. The clinical specialty of otology started in France (1850s), emerged as a scientific specialty in England, and received explosive progress from the German-speaking countries at the end of the nineteenth century. Otology has a remarkable background.

La fascinante e ingeniosa historia de los intrusos en vías aereodigestivas superiores y el nacimiento de la endoscopía en el Uruguay / The fascinating history of intrusives in upper aerodigestive tract and the birth of endoscopy in Uruguay

Se hace una extensa revisión de la historia de los cuerpos extraños en vías aéreas y digestivas superiores; los distintos procedimientos diagnósticos y las curiosas terapéuticas empleadas. Hacia fines del siglo pasado, las estadísticas mostraban una alta mortalidad, cercana al 40 por ciento en los intrusos esofágicos y al 50 por ciento en los traqueobronquiales. Esta última cifra descendía al 30 por ciento cuando se practicaba la traqueotomía. Se revisa la creación de la endoscopía directa desde Desormeaux a Killian, hacia fines del Siglo XIX. Se completa el artículo con las conclusiones de la investigación histórica efectuada sobre los orígenes de la endoscopía en el Uruguay, refiriendose los primeros exitos: Guillermo French (1881), traqueotomía por cuerpo extraño, Manuel Quintela (1900), extracción huesos en laringe y en 1905, el mismo Quintela, en la primera esofagoscopía directa exitosa. Finalmente, Pedro Martino, ORL académico con estudios de postgrado en Viena y Freigurg, realizó broncoscopías y esofagoscopías a partir de 1907 y comienza una especialización, que lo hace merecer el título "1er. Endoscopista del Uruguay"

[History of esophagoscopy]. / Zur Geschichte der Oesophagoskopie.

Since the middle of the 19th century very many experts have endeavoured to develop the oesophagoscopy following two different principles of oesophagus examination. Some tried to transfer the technique of indirect laryngoscopy on the oesophagus by using a larynx speculum. In order to achieve an insight into the oesophagus they separated its closed upper end by means of special retracting instruments. Various instruments were developed for this purpose (by Voltolini, Semeleder, Stoerk, Bevan, Waldenburg, Mackenzie) which however not proved to be effective. Mostly angled or jointed tubes came into use which were stretched after insertion. More successful were those applying simple straight tubes. Except for Stoerk it was Kussmaul who had a sword-swallower swallow a tube instead of a sword. Today flexible fiberglass endoscopes are used as well as rigid tubes.

Doctor Georg Handell and the knife swallower of Halle.

Handell was presented with a most difficult therapeutic problem when he saw Rudloff. Laparotomy was being done for the suturing of intestinal wounds incurred in battle during the last part of the 17th century but the report by von Dreyhaupt does not mention operative removal of the knife as a method of treatment. If Handell knew this information, he may have thought that the risk of an operation to remove a knife which had been in place for a prolonged period of time was prohibitive.

Perforation of the colon by ingested chicken bone, leading to diagnosis of carcinoma of the sigmoid.

The patient described is the first reported case of a chicken bone perforating a tumorous narrowing of the lumen of the colon. Although unique, it illustrates one mechanism of foreign-body perforation of the bowel and underscores the advantage for prompt examination of all operative specimens.