Designed by Surgeons. Loved by Nurses.
The Melzi Sharps Finder, designed by surgeons, streamlines the search for lost surgical needles and sharps. Compatible with a 5mm trocar, it supports open, laparoscopic, and robotic surgeries. It is indicated for use in gastroenterology and urology surgeries.⁴
How it works
Step 1
Clear the surgical area of metal items (trocars, instruments, retractors) to minimize interference—aim for a grapefruit-sized space.
Step 2
Pull the tab to activate. Device will give audible and visual feedback. Test with a needle to gauge detection distance. If retractors are present, start the sensitivity slider on low.
Step 3
Start searching at the last manipulated area. If not found, sweep systematically from the upper right quadrant to the pelvis.
Applications
Find Lost Sharps
A surgeon or OR staff realizes a needle, broken instrument piece, guidewire, or sharp is lost inside the patient, immediately activate the Melzi Sharps Finder to assist in manual search while waiting for an X-Ray. Cancel X-Ray when found.
Manage Miscounts
Bring the Melzi Sharps Finder to all surgeries with a large needle count or multiple staff changes. When a miscount happens, do a recount. If it’s still incorrect, use the Melzi Sharps Finder to sweep through the patient body in-vivo.
Emergency Operation
A Joint Commission report⁵ shows that RSIs were 9x more likely to occur when an emergency operation was performed and 4x more likely when the procedure changed unexpectedly midway. MSF can be used at the end of the case to quickly sweep through the surgical area to ensure no sharp is left behind.
High Needle/Instrument Count
When the surgical team unanimously agrees that the number of surgical instruments utilized during the OR procedure prohibits an expeditious count, it is helpful to use MSF to sweep through the patient's cavity.
Managing a Miscount
Results
Melzi Sharps Finder vs Manual Search
A multiphase preclinical assessment of the Melzi Sharps Finder to locate surgical needle: Users were randomized to two groups to determine if the needle was present in the abdomen, and to locate the needle if present: (1) manual search alone and (2) manual search with assistance of MSF. The trials were randomized regarding the presence and absence of needles, needle size, and location. ⁶
A total of 49 trials were performed with two groups using the laparotomy porcine model. The distribution of needle size, needle location, and the presence of a needle between the groups were comparable. The success rate of the MSF group was significantly greater than that of the manual search group (97% vs. 46.7%, p<0.001). with the time to determine in the MSF group (2.0 min ±1.5 vs. 3.9 min ±1.5, p<0.001).
| Ability | Manual Search | Sharps Finder (MSF) |
|---|---|---|
| If needle present | 22.2% | 95.4% |
| If needle absent | 83.3% | 100% |
| Time to determine | 3.9 minutes | 2.0 minutes |
Suture / Needle Size Detectability
The Melzi Sharps Finder goes into the patient body for closer and more accurate search for metallic objects including surgical needles, instruments, broken fragments, and guidewires. It can detect needles that are unlikely visible to X-ray.
| large | Medium | Small | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Needle size | 26 mm | 22 mm | 17 mm | 15 mm | 13 mm | 11 mm | 10 mm | 9 mm | 8 mm | 7 mm | |
| X-ray effectiveness | Detectable | Decreased Detection | X-Ray Ineffective DO NOT USE | ||||||||
| MSF | Detectable | ||||||||||
| Needle Size | X-ray Effectiveness | MSF |
|---|---|---|
| 26mm | Detectable | Detectable |
| 22mm | ||
| 17mm | ||
| 15mm | Decreased Detection | |
| 13mm | ||
| 11mm | ||
| 10mm | X-Ray Ineffective DO NOT USE | |
| 9mm | ||
| 8mm | ||
| 7mm |
Frequently Asked Questions
How often are needles and sharps lost during surgery?
More often than most OR teams expect. Suture needles are the most frequently lost surgical item, accounting for roughly 43% of missed-item events in a recent six-year study*, with broken instrument fragments making up another 20%. Miscounts and lost sharps are routine events in high-volume ORs, and the risk rises with minimally invasive and robotic procedures, where small needles are used in a confined field.
Why doesn't an intraoperative X-ray reliably find a lost needle?
X-rays have excellent specificity but poor sensitivity for small metallic objects. A study published in the British Journal of Radiology found intraoperative radiographs detected only 30% of retained surgical items, meaning roughly 70% were missed. Small needles, needle fragments, and objects overlapping bone or dense tissue are the most commonly missed*.
* A summary of this study can be found on this blog.
What size needle can an X-ray detect, and what size can't it?
Needles 17 mm or longer are generally detectable on X-ray. Below that, detection falls off sharply: in a study published in the Journal of Surgical Reconstruction, only 13% of surgeons could identify a 13 mm needle on a radiograph, and needles 10 mm or smaller are widely considered undetectable on X-ray. Many of the needles used in laparoscopic and robotic surgery fall in that small range.
* Summary of this article can be found on this blog
What does a retained surgical item cost a hospital?
The costs stack up in three places. Time: an X-ray adds roughly 40 to 75 minutes to a case, and the average miscount takes about 45 minutes to resolve. Dollars: each minute of OR delay costs an estimated $36 to $100 or more, before any readmission or re-operation. Liability: retained surgical items are a Joint Commission sentinel event and a "never event" for CMS, which means non-reimbursement, reporting obligations, and significant litigation exposure for the hospital and the surgeon.
What are the Joint Commission and AORN expectations when a count is incorrect?
Both expect a documented, standardized reconciliation process: a full recount, a methodical search of the field and surroundings, imaging when the item is not found, and documentation of the outcome. AORN's guideline on prevention of retained surgical items specifically encourages the use of adjunct technology to supplement manual counts.
Does a negative X-ray mean the patient is clear?
No. A negative X-ray should not be treated as definitive proof that nothing was left behind, particularly when the missing item is a small needle or fragment and clinical suspicion remains. Please reference the conclusion section of the British Journal of Radiology article. A "clean" film can give the team a false sense of security while the object remains in tissue. This is exactly why supplemental detection tools exist.
What can the Melzi Sharps Finder detect?
The Melzi Sharps Finder detects ferromagnetic metallic objects inside the surgical field: suture needles, broken instrument tips and fragments, guidewires, and similar metallic sharps. It is designed specifically for the small items that are hardest to find by hand or on imaging.
What's the smallest needle it can find?
The Sharps Finder detects needles down to 7.0, including sizes well below the threshold where X-ray becomes ineffective. In the needle-size ranges that X-ray cannot reliably image (roughly 10 mm and under), the Sharps Finder remains fully effective.
Can it detect sponges, textiles, or non-metallic items?
It depends. The Sharps Finder detects metallic objects only. It is not a replacement for sponge-counting or RF sponge-detection systems; it addresses a separate problem those systems don't cover - small metallic sharps. However, there are a couple of sponges on the market with metallic casings that can be detected by the Melzi Sharps Finder.
How close does it need to be to the object to detect it?
Detection is proximity-based, so the probe is swept systematically through the surgical area rather than held at a distance. Before each use, the team tests the device against a known needle to gauge its detection range for that case. Detection distance depends on needle size and sensitivity setting.
How does it signal a find?
The device gives both audible and visual feedback when it detects a metallic object, so the whole team knows immediately.
How is it different from a metal detector or an RF sponge-detection system?
A handheld metal detector works by detecting signals from outside the body. It is not sterile and cannot resolve a small needle through tissue. RF sponge systems detect tagged textiles only, not needles or fragments. The Melzi Sharps Finder is designed to go inside the patient, either through a 5 mm trocar or into an open field, to detect metallic objects at close range.
Does it replace the X-ray, or supplement it?
It supplements it. In practice, the Sharps Finder is used immediately when a count comes up short, while the team waits for radiology. If the item is found, the X-ray can be canceled, saving the delay and the radiation exposure. If it is not found, the X-ray proceeds as it would have anyway, potentially at the end of the case before skin closure (please download complimentary Perioperative Surgical Count & Miscount Management Guideline as reference). Each hospital sets its own protocol when X-ray is still required.
Which procedures is the Melzi Sharps Finder indicated for?
The target group of the device application are patients undergoing a laparoscopic procedure or an open procedure in gastroenterology and/or urologic surgeries.
Does it fit through a 5 mm trocar? What about 8 mm robotic ports?
Yes. The Sharps Finder is compatible with a standard 5 mm trocar, which also means it passes through 8 mm robotic ports and larger access ports.
Can it be used in open cases, or only in minimally invasive cases?
Both. In open surgery, the probe is swept directly through the field; in laparoscopic and robotic cases, it is introduced through a port. The search technique is the same: start at the last manipulated area, then sweep systematically.
Does it interfere with retractors, staplers, or other metal in the field?
Nearby metal can trigger the device, so the recommended setup is to clear metallic items from the search area where possible (aim for a grapefruit-sized space) and, if retractors must remain, start the sensitivity slider on low. With that setup, teams can search effectively even in fields with retractors in place.
How long does a typical search take?
In a preclinical comparison, the Sharps Finder group located or ruled out a needle in an average of 2.0 minutes, compared with 3.9 minutes for manual search alone, and achieved a 95% success rate when a needle was present, versus 22% for manual search⁶.
Where does it fit in our miscount protocol?
Most customers add it at a single point: after the initial recount confirms the discrepancy, and before or while radiology is being called. Use the Sharps Finder to sweep the surgical area; if the item is found, cancel the X-ray and document the recovery. Melzi provides a sample utilization guideline that OR leaders can adapt to their existing policy.
Is it sterile? Single-use or reusable?
The Melzi Sharps Finder is supplied sterile and is single-use, so there is no reprocessing, no battery maintenance, and no calibration between cases. Pull the tab to activate, and the device self-tests with audible and visual feedback.
How much training does the OR team need?
Minimal. The device has three steps: clear the area, pull the tab and test against a needle, then sweep. Most teams are comfortable after a short in-service, and Melzi provides a 10-second demonstration video, a quick-reference card, and in-person or virtual in-servicing for accounts.
Can it be used at the end of a high-count case even when the count is correct?
Yes. Some teams use it as a final sweep in cases with a high needle count, multiple staff changes, or emergency procedures, where Joint Commission data* shows retained-item risk is several times higher. This is a protocol decision for the facility; the device does not require a miscount to be used.
*The Joint Commission. Sentinel Event Alert, Issue 51: Preventing unintended retained foreign objects. October 17, 2013. (current PDF: https://digitalassets.jointcommission.org/api/public/content/52622a8f295d45168bc88dc199796085)
Is the Melzi Sharps Finder FDA registered and listed?
Yes. The Melzi Sharps Finder is FDA registered and listed, Class II Exempt.
What clinical or pre-clinical data supports it?
A multiphase preclinical assessment compared manual search alone with manual search assisted by the Sharps Finder in a porcine laparotomy model. Across 49 randomized trials varying needle presence, size, and location, the Sharps Finder group succeeded 97% of the time versus 46.7% for manual search (p < 0.001), and reached a determination in about half the time⁶.
What were the detection rates compared to manual search?
When a needle was present, the Sharps Finder group found it 95.4% of the time, compared with 22.2% for manual search. When no needle was present, the Sharps Finder group correctly confirmed that 100% of the time versus 83.3% for manual search. Time to determination averaged 2.0 minutes versus 3.9 minutes⁶.
by the Melzi Sharps Finder.
Is it safe to use inside the patient?
The device is designed and tested for in vivo use within its indicated procedures and has been evaluated for biocompatibility and electrical safety. It is sterile, single-use, and produces no thermal or cutting energy.
Does it interact with active implants, pacemakers, or other devices?
The interaction with active implants, pacemakers, or other similar devices has not been evaluated.
Which health systems are using it today?
The Melzi Sharps Finder is in use at more than 100 facilities, including community and teaching hospitals, Veterans Affairs medical centers, and both for-profit and non-profit health systems across the U.S. Reference accounts can be provided on request.
Does using it create any documentation or charting requirement?
Only what your existing miscount policy already requires. Most facilities note in the count reconciliation record that the Sharps Finder was used and whether the item was recovered.
What does the Melzi Sharps Finder cost?
The Sharps Finder is sold in boxes of 5 units, with volume pricing available to health systems. We are sold via local distributors in most states, and we can connect you with your onsite sales reps.
What's the ROI compared to one X-ray delay, or one retained surgical item?
A single avoided intraoperative X-ray saves 40 to 75 minutes of OR time, worth roughly $1,500 to $7,500 at typical OR cost rates, plus radiology charges. A single avoided retained-item event avoids re-operation, extended stay, CMS non-reimbursement, and litigation that commonly runs into six or seven figures.
Does it reduce OR time, and by how much?
It depends on each situation. In practice, the greater savings come from avoiding the X-ray entirely: when the device finds the item, the 40- to 75-minute imaging delay is eliminated and the case proceeds. In one situation, an institution avoided a conversion to open laparotomy when an instrument broke (see story attached)
Is there a reimbursement code?
No. The Sharps Finder is a cost-of-care item, like a sponge-detection system, rather than a separately reimbursed procedure. Its value is in avoided cost and avoided risk.
Can we trial it before committing it?
Yes. Melzi offers an evaluation program so a facility can use the Sharps Finder in live cases before a purchasing decision. Please contact us.
What do I need to bring to our value analysis committee?
Melzi provides a value analysis packet that includes the clinical review, product specifications and IFU, pricing, reference accounts, a one-page ROI summary and other requested items.
How does it affect our malpractice or risk profile?
Retained surgical items are among the most common and most expensive surgical claims. Adopting a documented adjunct-detection step in your miscount protocol demonstrates a standard of care beyond count-and-X-ray, which risk managers generally view favorably. Melzi cannot provide legal advice; we recommend discussing it with your risk management and insurance partners.
Is it available under a GPO contract?
We are on the Premier Contract (BT-OR-001). We are continuously adding other GPO contracts, so please contact us directly for the latest updates.
How do we place an order?
Orders can be placed directly with Melzi by contacting orders@melzicorp.com or through the contact form on this site. A member of the sales team will confirm pricing, quantity, and shipping and provide the documents your supply chain needs.
What's the minimum order quantity and lead time?
The minimum order is 5 units per box. Standard orders ship within 3 business days.
What's the shelf life and how should it be stored?
The Sharps Finder has a shelf life of 2 years from the date of manufacture and should be stored at room temperature in its sealed sterile packaging.
Is there a part number or SKU for our item master?
| Name | Description | Part Number |
| Melzi Sharps Finder | For going through trocars | FG70003-5P |
| Melzi Sharps Finder, Short | For open surgery | FG70350-5P |
Who handles in-servicing and training for our staff?
Melzi provides in-servicing for every new account, delivered in person or virtually by our clinical team, along with a demonstration video, quick-reference card, and a sample utilization guideline. Training typically takes 10-15 minutes per team.
Do you offer a champion or superuser program?
Yes. Melzi's champion program designates an OR leader at each customer facility as the Sharps Finder point person, with additional training, materials, and a direct line to Melzi's clinical team.
Who do we contact for support, reorders, or a clinical question?
Reorders and account questions: orders@melzicorp.com
Clinical or technical questions: support@melzicorp.com
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Product Brochure
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