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Preliminary in Vitro Study on an RFID-Tagged Gauze Detection System to Prevent Retention During Laparoscopic Procedures

Jae Kyun Park, Hwan Yi Joo, Dae Hwan Kim, Tae-Yong Jeon, Seokyoung Ahn, C. Choi

Surgical Innovation, 2026

Abstract

BackgroundRetained 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.MethodsWe 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.ResultsDetection 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.ConclusionsThis proof-of-concept study demonstrates that an RFID-integrated laparoscopic port can achieve high…

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