Presentation Authors: Colby Dixon*, Resha Tejpaul, Michael Borofsky, Minneapolis, MN
Introduction: Though uncommon, the medicolegal ramifications of wrong sided surgery are catastrophic. While skin marking is a proven technique to confirm laterality in open surgical procedures, it is less useful in endoscopic procedures as markings are covered by drapes and not visible on fluoroscopic imaging. Recently a novel radiopaque tape marker (&[Prime]X Site&[Prime], Target Tape Inc; Surrey, British Columbia) was introduced to assist in confirming laterality for patients undergoing endourologic surgery. We sought to assess this in clinical practice.
Methods: 40 patients undergoing upper tract endourologic surgery had an X Site sticker applied preoperatively to their torso 4 fingerbreadths lateral to the umbilicus. Visualization of the sticker was then confirmed on intraoperative fluoroscopic imaging. Patients and surgeons were surveyed 1-2 days following the procedure regarding their satisfaction with the sticker as well as intraoperative or postoperative issues with its use.
Results: The X Site sticker was readily apparent on fluoroscopy when placed 4 fingerbreadths lateral to the umbilicus in all but one case despite a wide range in patient body mass index (22.7-43.8, mean 29.9). There were no cases of the sticker being dislodged or obscuring views of the kidney or ureter. Among respondents to the post procedure survey, there were no reports of local reaction from sticker application. The majority of patients (11/14, 79%) reported that the sticker improved their concerns about wrong sided surgery.
Conclusions: We found the X Site marker to be reliable and readily identifiable in 95% of cases when applied in the described fashion. Application of the X Site sticker has the potential to improve patient safety and prevent wrong sided endourologic surgery by allowing real time confirmation of laterality on fluoroscopic imaging.