Using Artificial Intelligence Deep Learning to Detect and Prevent Retained Surgical Sponges

Retained surgical items (RSIs) remain a persistent challenge in patient safety, with retained surgical sponges (RSS) being the most common. Traditional RSI prevention methods, including manual counting, radiofrequency identification (RFID), and radiography, have demonstrated limitations, leading to persistent surgical errors. Artificial intelligence (AI), particularly deep learning models, has emerged as a promising solution for improving RSS detection and reducing human error in the operating room. This review examines the application of AI in RSI prevention, focusing on deep learning techniques such as Convolutional Neural Networks (CNNs) and Artificial Neural Networks (ANNs). CNN models analyze visual data such as images and videos, while ANN models recognize complex data patterns. Studies have demonstrated that CNN-based models significantly enhance RSS detection in x-rays and laparoscopic video feeds, often outperforming human observers. Object detection models, such as YOLO (You Only Look Once), have shown promise in real-time RSS tracking, making them particularly valuable in complex surgical environments. In addition, ANN-based computer-aided detection (CAD) systems, when combined with radiopaque markers, have improved accuracy in identifying retained sponges. Despite these advancements, several challenges remain, including data set limitations, false positives, and difficulties distinguishing gauze from surrounding tissue. Further research is needed to refine these models, expand their applications beyond RSS, and integrate them effectively into surgical workflows. The adoption of AI-based detection systems has the potential to enhance patient safety, reduce health care costs, and prevent surgical never events, marking a crucial step toward reducing RSIs in modern surgical practice.