Whats the Lap Count?

As a third year medical student in the operating room, our duty is to create an open surgical space through the intricate art of retracting. On top of that, you have to be ready for any question the surgeon may ask you at any time during the case. This process of ‘getting pimped’ is nerve-racking to most medical students, but it ensures that you’ve read up on the anatomy and the patient prior to the case.

After scrubbing into the OR recently, the surgeon turned to me. “Ok, you are in charge of the lap count.” I stood there puzzled as if he was confusing me with the scrub nurse or something. He explained that on top of my retracting, he wanted me to take note of exactly how many lap sponges were in the abdomen at all times. Although a small task, I was excited to be more actively involved in the surgical case.

As the case progressed, he would pause for a split second and ask, ‘Whats the lap count?”. Having kept a keen eye out, I immediately responded with the right answer. Now although I know that many other people in the room, including the surgeon, were well aware of the lap count at all times, the surgeon wanted me more involved in the case. As the case was wrapping up, the surgeon handed me the sutures and allowed me to close. He explained to me that that the lap count may seem like a trivial task in the grand scheme of an open colectomy, but it actually is extremely important. In fact, at times the lap count becomes more important than finishing the procedure on time. Reflecting back, I think it was a great sign of leadership that the surgeon utilized all his resources in the OR in order to have a successful case.