[leguminous]

When my wife had some minor surgery (not fully anesthetized), there was a nurse present who counted all of the sponges, etc. that were used, then made sure there were that many on the tray at the end. They didn't match up, and it turned out that the surgeon had dropped one off of the table.

The article mentions that counting is standard procedure, so hopefully this is how it works everywhere. It definitely seems like having someone who isn't the surgeon doing the counting would be the way to go. The surgeon is already very focused and it's easier to say "I'm sure I didn't leave anything" when someone else isn't telling you otherwise.

[npsomaratna]

Doctor here (non-USA). This is standard procedure and has been standard ever since I was a medical student, almost 20 years ago. The "running nurse" is in charge of maintaining a count and making sure that nothing is left inside the patient.

Swabs and towels tend to come in pre-prepared packs, so the nurses have another source of truth. Any mismatch between the preprepared count, running count during the operation, and actual swabs/towels laid out at the end is a serious cause for concern. You will not close up a patient if there is a mismatch.

[matwood]

Yeah, back in the late 90s I was able to observe a number of surgeries (different story) and I remember the counting being almost fanatical. They had what looked like a shoe holder that hung on a door for putting each rag that was used. Every instrument that was used was accounted for during and after. The surgeon was definitely not the counter.

[aelhage]

My wife is an OR nurse and jokes her primary job responsibility is counting. Frequently when surgery is going long it's because someone threw out or dropped something that was supposed to be accounted for and they won't close the patient up until that's found, even if that means sorting through the garbage.