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RACS ASC 2026
Swabs to With-hold Irrigation and Promote Surgical Efficiency (SWIPE-TNH): A prospective study
Verbal Presentation

Verbal Presentation

4:00 pm

01 May 2026

River View Room 5

Environmental Sustainability in Surgery

Presentation Description

Institution: Northern Health - Victoria, Australia

Purpose: Routine use of disposable suction/irrigation devices (SIDs) in elective laparoscopic cholecystectomy (LC) is widespread to maintain operative field clarity. Substituting fabric swabs within Morrison’s pouch may offer a cost‑effective and sustainable alternative without adversely affecting outcomes. This study aimed to assess the feasibility of omitting routine SID use by utilising fabric swabs. Secondary objectives were to describe patient demographics, intraoperative and postoperative complications, and surgeon satisfaction with swab usage. Methodology: Twenty consecutive adult patients undergoing elective LC for biliary colic at Broadmeadows Hospital (Northern Health) were prospectively identified after applying exclusion criteria. After establishing pneumoperitoneum, a fabric swab was placed in Morrison’s pouch. Surgeons could deploy a SID at any point if clinically indicated. The primary outcome was the proportion of cases completed without SID use. Secondary data included operative duration, complications, and surgeon satisfaction with swab use measured via Likert scale. Results: A significant proportion of cases (42.1%) were completed without the need for a SID, demonstrating that SID use was not universally required. SID devices were opened in 57.9% of cases, most commonly for bile or blood spillage. Only 47.4% of SID use occurred after swab inspection, suggesting predominantly reactive rather than pre‑emptive use. Postoperative complications were infrequent and comparable across operator experience levels. High satisfaction was reported for field clarity, patient safety, and feasibility without SID, although perceived operative efficiency was moderate. Conclusion: Elective LC can be safely and effectively performed without routine SID use when fabric swabs are employed. Surgeon satisfaction remained high and complication rates were low. Selective rather than routine SID deployment may therefore be appropriate, offering potential cost and environmental benefits without compromising outcomes.
Presenters
Authors
Authors

Dr Ranesh Palan - , Dr Eamonn Grennan - , Professor Russell Hodgson -