Dr. Ng has espoused the use of an absorbent sponge during laparoscopy for many years, both for simple and advanced procedures. I am chagrined and apologetic that I did not reference his publications in our description of this useful tool, the simple explanation being that it did not come up in my literature search on the subject (key words “sponge,” “gauze,” “laparoscopy”).

In Dr. Ng’s letter regarding use of this simple tool, he has emphasized a number of points that I fully agree with and that are worth bearing in mind.

Firsts any introduced sponge must be carefully kept track of—once soaked with blood or debris, they can easily become invisible. Use of the “one-for-one policy” and an alert nurse/assistant can prevent problems with a lost or forgotten sponge, as can the suture tied to the sponge. Of course, either technique is acceptable; I use both. I have not found the suture tail cumbersome; to the contrary, I find that it aids in easy removal through the trocar.

Seconds the sponge is highly useful for common operations—not only for keeping a clean field, but to control bleeding, mop up debris in contaminated cases, and as a blunt retractor.

We encourage surgical trainees to use sponges liberally. They are inexpensive and efficient.