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Current Evidence for Minimally Invasive Surgery During the COVID-19 Pandemic and Risk Mitigation Strategies: A Narrative Review.
Chadi, Sami A; Guidolin, Keegan; Caycedo-Marulanda, Antonio; Sharkawy, Abdu; Spinelli, Antonino; Quereshy, Fayez A; Okrainec, Allan.
  • Chadi SA; Department of Surgery, Faculty of Medicine, University of Toronto and University Health Network, Toronto, Canada.
  • Guidolin K; Department of Surgery, Faculty of Medicine, University of Toronto and University Health Network, Toronto, Canada.
  • Caycedo-Marulanda A; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada.
  • Sharkawy A; Department of Surgery, Queens University and Kingston General Hospital, Kingston, Canada.
  • Spinelli A; Department of Medicine, Faculty of Medicine, University of Toronto and University Health Network, Toronto, Canada.
  • Quereshy FA; Division of Colon and Rectal Surgery, Humanitas Clinical and Research Center, IRCCS, Rozzano, Milano, Italy.
  • Okrainec A; Department of Biomedical Sciences, Humanitas University, Rozzano, Milano, Italy.
Ann Surg ; 272(2): e118-e124, 2020 08.
Article in English | MEDLINE | ID: covidwho-704742
ABSTRACT

OBJECTIVE:

Our objective was to review the literature surrounding the risks of viral transmission during laparoscopic surgery and propose mitigation measures to address these risks. SUMMARY BACKGROUND DATA The SARS-CoV-2 pandemic has caused surgeons the world over to re-evaluate their approach to surgical procedures given concerns over the risk of aerosolization of viral particles and exposure of operating room staff to infection. International society guidelines advise against the use of laparoscopy; however, the evidence on this topic is scant and recommendations are based on the perceived most cautious course of action.

METHODS:

We conducted a narrative review of the existing literature surrounding the risks of viral transmission during laparoscopic surgery and balance these risks against the benefits of minimally invasive approaches. We also propose mitigation measures to address these risks that we have adopted in our institution. RESULTS AND

CONCLUSION:

While it is currently assumed that open surgery minimizes operating room staff exposure to the virus, our findings reveal that this may not be the case. A well-informed, evidence-based opinion is critical when making decisions regarding which operative approach to pursue, for the safety and well-being of the patient, the operating room staff, and the healthcare system at large. Minimally invasive surgical approaches offer significant advantages with respect to both patient care, and the mitigation of the risk of viral transmission during surgery, provided the appropriate equipment and expertise are present.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Operating Rooms / Pneumonia, Viral / Infection Control / Laparoscopy / Infectious Disease Transmission, Patient-to-Professional / Coronavirus Infections / Minimally Invasive Surgical Procedures Type of study: Experimental Studies / Observational study / Prognostic study / Reviews Limits: Humans Language: English Journal: Ann Surg Year: 2020 Document Type: Article Affiliation country: SLA.0000000000004010

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Operating Rooms / Pneumonia, Viral / Infection Control / Laparoscopy / Infectious Disease Transmission, Patient-to-Professional / Coronavirus Infections / Minimally Invasive Surgical Procedures Type of study: Experimental Studies / Observational study / Prognostic study / Reviews Limits: Humans Language: English Journal: Ann Surg Year: 2020 Document Type: Article Affiliation country: SLA.0000000000004010