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Background: The coronavirus disease 2019 (COVID-19) disrupted the delivery of elective surgery in children. We introduced guidance to mitigate this impact. By reviewing the outcomes for inguinal herniotomies, we aimed to determine if this guidance has enabled us to prevent an increase in the elective surgery wait time and therefore the need for emergency surgery for incarcerated hernias. This report aims to share our learnt lessons about responding to a crisis limiting accessibility to elective surgery. Results: We performed a retrospective review of all elective and emergency herniotomies performed between April 1 and September 30, 2019 (pre-COVID-19) and the same period in 2020 (post-COVID-19). We compared the data on wait time from referral to clinic review/elective surgery and incarceration rates. During the study period in 2019, 76 elective herniotomies were performed compared to 46 in 2020. We did not observe a simultaneous increase in emergency herniotomies in 2020 (27 [2020] vs 25 [2019], OR [95% CI] = 1.53 [0.79-2.9]; p = 0.2). The median time from referral to elective surgery in 2019 compared to 2020 did not differ (56 vs 59 days, respectively; p = 0.61). In 2020, 72% of children that required emergency surgery had not been previously referred to our service and the median age (interquartile range) at which they presented with an incarcerated hernia was 2.8 months (2.1-13.7 months). Conclusion: By adhering to local guidelines for resumption of elective activity, the pandemic did not result in children waiting longer to be seen by a surgeon for a suspected inguinal hernia. As a result, we did not perform more emergency herniotomies. Urgent prioritisation of hernias in infants, from birth up to 3 months old, was a beneficial strategy. Public health education on childhood hernias will improve outcomes. Supplementary Information: The online version contains supplementary material available at 10.1186/s43159-023-00243-1.
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Anxiety contributes to postsurgical pain, and midazolam is frequently prescribed preoperatively. Conflicting results have been described concerning the impact of midazolam on pain. This study aims to evaluate the effect of systemic midazolam on pain after open inguinal hernia repair, clarifying its relationship with preoperative anxiety. A prospective observational cohort study was conducted in three Portuguese ambulatory units between September 2018 and March 2020. Variable doses of midazolam were administered. Postsurgical pain was evaluated up to three months after surgery. We enrolled 306 patients and analyzed 281 patients. The mean preoperative anxiety Numeric Rating Scale score was 4 (3) and the mean Surgical Fear Questionnaire score was 22 (16); the mean midazolam dose was 1.7 (1.1) mg with no correlation to preoperative anxiety scores. Pain ≥4 was present in 67% of patients 24 h after surgery and in 54% at seven days; at three months, 27% were classified as having chronic postsurgical pain. Preoperative anxiety correlated to pain severity at all time points. In multivariable regression, higher midazolam doses were associated with less pain during the first week, with no apparent effect on chronic pain. However, subgroup analyses uncovered an effect modification according to preoperative anxiety: the decrease in acute pain occurred in the low-anxiety patients with no effect on the high-anxiety group. Inversely, there was an increase in chronic postsurgical pain in the very anxious patients, without any effect on the low-anxiety group. Midazolam, generally used as an anxiolytic, might impact distinctively on pain depending on anxiety.
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Aim: There are data showing that the use of minimally invasive anesthesia methods (local anesthesia, nerve blocks) as an alternative to traditional anesthesia methods used in inguinal hernia repair surgery is safe and effective. During the COVID-19 pandemic, which affected the whole world, we aimed to evaluate the use of minimally invasive anesthesia methods in patients with inguinal bladder hernia, as well as their perioperative and postoperative results in our pilot study. Material(s) and Method(s): We evaluated the perioperative and postoperative data of five patients with inguinal bladder hernia, who underwent surgery with local anesthesia and ilioinguinal/iliohypogastric nerve blockade, four of which were performed during the COVID-19 pandemic. Result(s): It is possible to perform inguinal bladder hernia surgery with local anesthesia and ilioinguinal/iliohypogastric nerve block, including in secondary cases. Better hemodynamic stabilization in the intraoperative period reduces the need for narcotic analgesics by providing effective analgesia in the postoperative period, as well as reducing the risk of contamination in airway control. Discussion(s): Performing inguinal bladder hernia surgery using local anesthesia and ilioinguinal/iliohypogastric nerve block provides reliable and effective analgesia during the perioperative and postoperative periods.Copyright © 2023, Derman Medical Publishing. All rights reserved.
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Advances in neonatal medicine have progressively increased the survival of premature infants. Increased survival has however come at the cost of increased number of infants with prematurity-related complications. This is represented by high rates of respiratory distress syndrome, bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), sepsis, periventricular leukomalacia (PVL), intraventricular haemorrhage (IVH), cerebral palsy, hypoxic ischaemic encephalopathy (HIE) and visual and hearing problems in survivors. In addition to prolonged hospital stay after birth, readmission to hospital in the first year of life is common if chronic lung disease exists. Around 3% of newborns have a congenital physical anomaly with 60% of congenital anomalies affecting the brain or heart and around 1% having multiple anomalies. Individual congenital conditions requiring surgical intervention in the neonatal period are rare. Neonates have a higher perioperative mortality risk largely due to the degree of prior illness, the complexity of their surgeries, and infant physiology. The maintenance of oxygenation and perfusion in the perioperative phase is critical as both affect cerebral perfusion and neurocognitive outcome but the triggers for intervention and the thresholds of physiological parameters during neonatal anaesthesia are not well described. After even minor surgical procedures, ex-premature infants are at higher risk for postoperative complications than infants born at term.Copyright © 2022
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INTRODUCTION: Inguinal hernia repair is one of the most common surgical procedures performed by general surgeons. Numerous articles have shown that robotic inguinal hernia repair is safe and effective, but also more costly than other hernia repair techniques. The robotic platform uses high-definition visualization and articulating instruments. A growing number of surgeons are using this technology to refine and obtain a critical view of the myopectineal orifice for hernia repair while lessening the pain associated with the open surgical approach. Lower insufflation pressures and good results without Foley catheterization have been reported. This report presents an update, with a focus on the past 3 years during the SARS COVID-19 pandemic, of a series of robotic, laparoscopic inguinal hernia repairs by a single surgeon with extensive laparoscopic hernia experience at a single institution, along with a review of the recent current literature. METHOD(S): Over 3000 laparoscopic inguinal hernia operations have been performed by the author since 1990. One hundred-fifty-eight were performed from April 2020 to November 2022, in addition to the previously reported 420 robotic TAPP (trans-abdominal pre-peritoneal) procedures performed from April 2012 to March 2020. Hospital records and follow-up care were prospectively reviewed and the patient's age, sex, American Society of Anesthesia (ASA) class and operative time were obtained. Follow-up was done at 2 weeks and 6 weeks following surgery. All patients consented to the use of their data in the study. RESULT(S): Ninety-four percent (94%) of the patients were male. The average age was 64.3 years (range 18-91). Co-morbidities included hypertension, hypercholesterolemia, prostatism and GERD, among others. BMI was between 19 and 37.1 (mean 26.1). In 23 patients (15%), an umbilical hernia repair was performed concomitantly. OR time ranged from 25 to 90 minutes (mean 51.8). Complications were uncommon and urinary retention (2.5%) was an infrequent post-operative occurrence. CONCLUSION(S): 1) Use of a lower insufflation pressure (8-12 mm Hg) was routine. 2) Use of a structural mesh (4x6 inches) gave satisfactory results. 3) While fixation of the mesh was not necessary, fibrin sealant was used routinely. 4) Urinary retention was infrequent, and did not require pre- or intra-op Foley catheterization if the patient voided immediately prior to surgery. Finally, 5) OR time was consistently less than 1 hour. These results support the conclusion that robotic inguinal hernia repair is safe and effective.
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PURPOSE: To investigate the impact of the COVID-19 pandemic on the clinical impact of the clinical outcomes of robotic inguinal hernia repair. METHODS: Patients who underwent RIHR 2 years before and after March 10, 2020, were included in this retrospective study and assigned accordingly to the pre- or post-COVID group. Pre-, intra-, and postoperative variables including patients' demographics, hernia characteristics, complications, and hernia recurrence rates were compared between groups. RESULTS: 183 (94.5% male) and 141 (96.4% male) patients were assigned to the pre- and post-COVID groups, respectively. Patient demographics and medical comorbidities did not differ between groups. Operative time was approximately 40 min longer in the post-COVID group (p < 0.001) with higher rates of bilateral IHR (pre-COVID: 30.1% vs. post-COVID: 46.4%, p = 0.003). Mesh material differed between groups with predominance of polyester mesh in the pre-COVID group vs. polypropylene in the post-COVID one. Median hospital length of stay (LOS) was 0 days in both groups, and same-day discharge rates were 93.4% pre-pandemic and 92.8% post-pandemic (p = 0.09). There were no pulmonary complications recorded in either group or no cases of COVID-19 detected within two weeks postoperatively in the post-COVID group. Seromas were more frequent in the post-COVID group (pre-COVID: 2 vs. post-COVID: 8, p = 0.018) and no hernia recurrences were recorded. CONCLUSION: This is the first study to describe the impact of COVID-19 on RIHR. Clinical outcomes and hernia-specific complications were not impacted by the COVID-19 pandemic.
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Background: Few studies have evaluated the efficacy of short-term medical missions. This study was aimed to evaluate complication rates and determine the effects of protocol changes in a pediatric inguinal hernia campaign in Equatorial Guinea and analyze post-operative follow-up capacity. Methods: In this prospective observational cohort study, we evaluated two patient cohorts (group A, 2017-2018; group B, 2019) treated during campaigns in Equatorial Guinea for congenital inguinal pathology (hernia, hydrocele, and cryptorchidism). Patients aged < 18 years treated in referral campaigns were included. Complications occurring up to 6 months post-operatively were evaluated. Two stages were defined: Stage 1, wherein, complication rate in group A was compared to that in a control group from a tertiary hospital in Spain (with a case-control ratio of 1:2, paired according to age, sex and diagnosis); stage 2, wherein, complication rates between groups A and B were compared. Group B received a single dose of prophylactic amoxicillin-clavulanic acid. Follow-up capacity was assessed through follow-up appointments. Results: In stage 1, complication and surgical site infection (SSI) rates were 21.3% and 7.4% in group A (n = 94), and 5.8% (p < 0.001) and 0.5% (p = 0.012) in the control group, respectively. Group A had 20.2% loss-to-follow-up. In group B (n = 62), 6-month postoperative follow-up could not be assessed owing to restrictions due to the COVID-19 pandemic, so only early complications were considered in stage 2, were complication and surgical site infection rates were 18.1% and 7.4% in group A and 11.3% (p = 0.350) and 1.6% (p = 0.150) in group B. Conclusion: Our results showed higher than expected complication rates. Pre-operative prophylactic antibiotic could not show to reduce SSI. Further studies are needed to reduce complication rates in these campaigns. Patient loss-to-follow-up ratio warrants considering new strategies.
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Aim: In this investigation, we looked at how the COVID 19 pandemic affected the number, complication rates, and epidemic features of patients who had surgery at our facility for inguinal hernias. Method(s): We conducted a retrospective analysis of all patients who underwent inguinal hernia operations at the Department of General Surgery Meenakshi Medical College and Research Institute, Kanchipuram, between November 2020 and November 2021. The descriptive statistics employed were percentages, means, standard deviations, medians, and interquartile ranges. When comparing two groups, the Mann-Whitney U test was applied to changes that deviate from the normally distributed spectrum. The Pearson Chi-Square test and Fisher's Exact test were used to investigate the relationships between qualitative variables. For all statistical analyses, 0.05 was deemed to be the significant value. Result(s): 65 individuals (Group 1) underwent surgery between November 2020 and November 2021, and 26 patients between March 11, 2020, and 2021. (Group 2). In Group 2, there was a statistically significant rise in the rate of incarceration and strangulation (44.6% in Group 1, 84.6% in Group 2, p=0.008) as well as a statistically significant rise in the proportion of female patients (4.6% in Group 1, 23.1% in Group 2, p=0.008). Conclusion(s): The rate of detention and strangling increased as during COVID-19 pandemic. The precipitous decline in elective procedures or the rise in the proportion of female patients admitted during the COVID period can be blamed for the rise in complication rates. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
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Background: Specialization influences the way that surgeons deliver care and has a direct impact on doctors, healthcare systems and patients. Hernias impact around 2% of the population and repairs are among the most common procedures performed globally. The European Hernia Society recognizes a growing need for specialist surgeons as abdominal wall surgery becomes more complex with newer techniques and more challenging cases being encountered. At this trust, a new specialized hernia clinic was implemented in response to COVID backlogs and the growing need and proven benefits of specialization. The project's aim was to review the impact on procedure wait times and outcomes for hernia repairs. Method(s): A retrospective review of patients undergoing hernia repairs between June 2019 to June 2021 was compared to similar patients who attended the hernia clinic between February 2021 to March 2022. Included operations were inguinal, femoral, and umbilical hernia repairs. Data collected included diagnoses, percentage of day case and wait times. Result(s): 59 patients underwent surgery pre-intervention with average wait times of 191 days. 72 post-intervention patients had an average wait of 59 days. 59 patients were still awaiting surgery post-clinic. Open surgery incidence increased from 66% to 79%. 86% of patients post-intervention were day cases, compared to 78% of pre-intervention patients. Conclusion(s): The new hernia clinic has reduced wait times for surgery and improved day-case rates despite more cases being performed as open procedures. Following these results, the clinic system shows great promise and hernia surgery has the potential to evolve as a sub-specialty.
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Background - Aim: Inguinal hernia repair is among the most common surgical operations worldwide with over 20 million performed yearly. During the COVID-19 pandemic most elective hernia repairs were canceled, leading to potentially detrimental effects on the patients suffering from them. The aim of this study was to assess the impact of the pandemic on inguinal hernias and elucidate its consequences. Material(s) and Method(s): Patients that underwent inguinal hernia repair at General Hospital of Amfissa from March 2018 to March 2022 were included in this study. Patients were divided into two groups before (Group A) and after (Group B) March 2020, the date on which the first lockdown was implemented in Greece. Result(s): Overall, 407 patients (382 males & 25 females) with a mean age of 69 (24-93) were included in this study. A 27.5% decrease in total surgeries was found during the Group B (236 vs 171 patients), but emergency surgeries significantly increased (17.3% vs 43.9%). Furthermore, there was a statistically significant increase in strangulated cases (15.3% vs 40.4%) and cases warranting a bowel resection (13.6% vs 39.2%). Mean length of hospital stay also significantly increased over Group B period (1.69 vs 3.02 days). Conclusion(s): Policies leading to cancelation of elective surgeries and reallocation of healthcare facilities in order to confront the COVID-19 pandemic have led to a significant delay in the management of inguinal hernias. Thus, a steep increase in emergency cases was observed, as a greater part of theses hernias are being left untreated and subsequently strangulated.
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Introduction: Vicissitudes including re-deployment, elective cancellations, and remote educational events have restricted training opportunities during The COVID pandemic. This study aimed to analyse COVID's impact on global Higher Surgical Trainee (HST) performance metrics including hospital adaptability and variance. Material(s) and Method(s): Intercollegiate Surgical Curriculum Programme (ISCp) portfolios of 50 HSTs (median age 36 (range 29-46) yr., female 15, male 35), including 191 six-month rotational placements, were analysed over two years (March 2019 to 2021). Primary effect measures were: operative logbook numbers, index procedures validated against curriculum requirements and Work Based Assessments (WBA). Result(s): During COVID-19, operative experience per placement declined 26.1% (median 211 vs. 156, p<0.010), with a 32.1% decline in trainee primary surgeon experience (162 vs. 110, p<0.010). Regarding index procedures: cholecystectomy declined 45.5% (11 vs. 6, p=0.027) and inguinal hernia 62.5% (8 vs. 3, p<0.010). WBAs were similar (17 vs. 13, p=0.364). Despite relative equivalence before COVID, median total number of operative procedures performed in District General Hospitals (DGH, n=65) were 40.9% fewer than Tertiary Hospitals (TH, n=110, p<0.010). Radar plots of composite metrics ranged from 11.1 to 75.6% coverage before (p=0.011) vs. 13.3 to 68.9% after COVID (p=0.015). Discussion(s): Hospital training metrics varied over five-fold, a difference likely amplified by COVID, with THs more adaptable to existential shared lessons.
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Background: Approximately 100,000 hernia repairs are performed in the UK annually, the vast majority in hospital usually under general anaesthetic. Due to increased pressure on hospital facilities especially after the COVID-19 pandemic the waiting times for non-emergency surgery for benign conditions has increased. This study outlines the development and feasibility of a dedicated ambulatory primary care hernia service and examines the outcomes achieved between November 2018 and November 2021. Method(s): We prospectively analysed of records of 212 patients who underwent hernia repair in a primary care centre during the above period. Inclusion criteria were a) BMI<35 b) uncomplicated inguinal or umbilical hernia c) non recurrent hernia. The techniques used were Lichtenstein mesh repair for inguinal hernias and a primary sutured repair for ventral hernias. All procedures were performed as day-cases under local anaesthesia without sedation. All patients were telephoned by a healthcare professional a day after their operation. The primary outcomes of the study were length of stay, immediate complications and the secondary outcome was cost effectiveness. Result(s): The median length of post-operative stay was 26 minutes. Complications were low and seen only in 5 patients and managed conservatively. The cost of hernia repair in primary care in UK is only 1012 when compared to 1800 in an NHS hospital. Conclusion(s): Routine elective abdominal wall hernia repairs can be performed in a primary care setting, safely, with good clinical outcomes and clear economic benefits. However, this depends on the availability of surgeons and adequate funds to establish the service.
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Aim: Themain aimof the project will be evaluating the effectiveness of an experimental structured didactic program in robotic surgery in filling the training gap caused by the pandemic. We intend to evaluate how establishing a training pathway could improve young surgeons' robotic skills and implement their participation in robotic procedures during the COVID-19 pandemic. We will also evaluate the learning curve of robotic transabdominal preperitoneal inguinal hernia repair (TAPP) for young surgeons with limited experience as first operators at the dual console. Matherials and Methods:Wedesigned an experimental stepwise training program in robotic surgery that starts from a first step of theoretical and laboratory lessons, followed by a second phase of bedside assistance training, and finally the completion of low complexity procedures by the trainees proctored at the dual console by senior surgeons. Robotic TAPP was selected as training model. The performance of each trainee will be registered in an evaluation data sheet and Learning scores will be recorded by the tutor with the evaluation of 6 corner steps of the procedure. Result(s): Preliminary results showed improved technical skills and increased team spirit and wellbeing. Conclusion(s): TAPP is a good training model because involves technical steps useful for more complex procedures. The robotic dual console represent an extraordinary training tool and a structured training program positively impacts technical skills and could help filling the training gap caused by the pandemic.
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Aim The coronavirus disease 2019 (COVID-19) pandemic resulted in a lockdown in South East Scotland on 23 March 2020. This had an impact on the volume of benign elective surgery able to be undertaken. The degree to which this reduced hernia surgery was unknown. The aim of this study was to review the hernia surgery workload in the Lothian region of Scotland and assess the impact of COVID-19 on hernia surgery. Methods The Lothian Surgical Audit database was used to identify all elective and emergency hernia operations over a six-month period from 23 March 2020 and for the same time period in 2019. Data were collected on age, gender, anatomical location of the hernia, hernia repair technique, and whether elective or emergency operation. Statistical analysis was performed using the chi-squared test in R-Studio, with a p-value of <0.05 accepted as statistically significant. Results The total number of hernia repairs reduced considerably between 2019 and 2020 (570 vs 149). The majority of this can be explained by a decrease in elective operating (488 vs 87), with the percentage of elective repairs reducing significantly from 85.6% to 58.4% (p<0.001). The inguinal hernia subgroup had a 24% rise in emergency operations from 21 to 26 operations, despite a reduction from 270 to 84 total inguinal repairs. There were just two elective hernia repairs carried out in the first three months of the 2020 study period (5.6% of all operations for April-June) compared to 265 (87.7%) for the same period in 2019 (p<0.001). No statistically significant differences were observed in the rates of laparoscopic versus open operating techniques across the two study periods on any analysis. The age and gender of the patients were similar over the two time periods. Conclusion The COVID-19 pandemic led to a marked reduction in the number of elective hernia repairs (especially incisional hernia surgery), with the effect most pronounced over the first three months of lockdown. Despite an overall reduction in total emergency operative figures, possibly due to more widespread use of non-operative strategies, there was still an increase in emergency inguinal hernia repairs during the lockdown. Further studies are needed to evaluate if the delays to elective operating will result in a long-term increase in the rates of emergency presentation.
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Background Associated advantages of ilioinguinal/iliohypogastric block and sedation versus general anesthesia (GA) for inguinal hernia repair have not been reported. The use of regional anesthesia (RA) is advantageous during the COVID-19 pandemic as it eliminates the need for airway manipulation.This study aimed to determine the association between postoperative recovery time when ilioinguinal/iliohypogastric block and sedation were utilized for inguinal hernia versus GA. Method This single-center retrospective study used multivariable logistic regression to model the anesthetic modality as a function of age, sex, body mass index (BMI), American Society of Anesthesiologists (ASA) physical status, major comorbidities to generate a propensity score for each patient for matching. Results After screening 295 patients, 80 patients each in the general and regional anesthesia groups were matched.RA was associated with a 35.6 minutes (95% CI: -46.6 to -25.0) shorter total postoperative recovery time when compared to GA without the increased preoperative time and adverse outcomes. Conclusions Inguinal hernia repair, when performed under ilioinguinal/iliohypogastric block and sedation, was associated with reduced postoperative recovery time. This can be advantageous during the time of the COVID-19 pandemic to reduce the risk of aerosol generation and shorten hospital stay. Future research can focus on establishing a causal relationship.
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The primary lesion sites included tongue (4 patients), concomitant retromolar and buccal mucosa (1 patient) and submandibular region (1 patient). B Results: b A total of 78 patients were included in the study, 20 patients in the endoscopic stenting group and 58 patients in the emergency surgery group. B Conclusion: b Elective surgery can be safely performed in patients recently diagnosed with COVID-19 Omicron variant with no significant difference in postoperative outcomes compared to patients without COVID-19. FACIAL DOG BITE IN THE ERA OF COVID DL Chang, HHC Ho Tuen Mun Hospital, Hong Kong SAR B Aim: b Dog bite is not uncommon in Hong Kong. [Extracted from the article] Copyright of Surgical Practice is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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Background: Health care burden has increased since the pandemic of Covid-19 has emerged. The healthcare resources are limited currently and majority surgeries have been postponed because of the current pandemic. Therefore, the main concern of carrying out any surgery at current point is mainly in those patients that are landing in emergency. Symptomatic inguinal hernia being a common presentation in emergency can be dealt by applying local anesthesia. Objective: To evaluate the outcome (in terms of efficacy and safety) of local anesthesia for managing symptomatic inguinal hernia in a tertiary care hospital during current Covid-19 pandemic. Methodology: It was a descriptive study.60 males were enrolled with inguinal hernia of age 30-60 years. IV line was secured and local anesthesia was administered under aseptic measures. Lichtenstein repair, a mesh technique was applied in all patients for treating the inguinal hernia. Patients were evaluated postoperatively after 2 hours and 6 hours for any complications. Results: Mean age of the patients was 38.2±10.542, Mean time to eat was 3.85 ±3.138. Mean time to ambulate was 4.37 ±2.51. Mean pain score was 5.78± 2.131 postoperatively and after 6 hours it was 2.24 ±0.84. Indirect hernia was present in 74% patients whereas direct hernia was present in 26%. 6.67% patients had nausea/vomiting, 3.3% developed hematoma and 1.67% had wound infection. Conclusion: Local anesthesia is effective in all patients who have to undergo inguinal hernia surgery, in terms of efficacy and safety.
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There was an increase in the number (%) of operations performed in 2020, 175 patients (38%) versus mean 158 patients (29%) I P i = 0.001. This is the first Australian study looking at the association of patient's pre-operative condition and FTR of patients who underwent major abdominal surgery. Twenty patients (74.1%) had incisional hernias, four patients (14.8%) had I de novo i Spigelian hernias, two patients (7.4%) were related to blunt trauma, and one patient had a lumbar hernia (3.7%). SMALL BITE VERSUS LARGE BITE STITCHING TECHNIQUE FOR LAPAROTOMY WOUND CLOSURE: A SYSTEMATIC R... Erwin Yii, James Onggo and Ming Yii Eastern Health, VIC B Background: b Mass closure with a continuous suture using large bite stitching technique has been widely accepted for midline laparotomy wound closures. All patients undergoing a surgical procedure from 1 April 2020-2030 June 2020 (COVID-19 pandemic period) were compared to patients pre-pandemic (1 April 2019-2030 June 2019). [Extracted from the article] Copyright of ANZ Journal of Surgery is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)