Transmission of SARS-CoV-2 in Surgical Smoke during Laparoscopy: A Prospective, Proof-of-concept Study.
J Minim Invasive Gynecol
; 28(8): 1519-1525, 2021 08.
Article
in English
| MEDLINE | ID: covidwho-988422
ABSTRACT
STUDY OBJECTIVE:
There are growing concerns regarding the potential risk of coronavirus disease transmission during surgery and in particular during minimally invasive procedures owing to the aerosolization of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) particles. However, no study has demonstrated this hypothesis. Here, we aimed to investigate the presence of SARS-CoV-2 in surgical smoke.DESIGN:
A prospective pilot study.SETTING:
A tertiary cancer center in northern Italy. PATIENTS Overall, 17 patients underwent laparoscopic procedures for the management of suspected or documented gynecologic malignancies. The median age was 57 years (range 26-77). The surgical indications included endometrial cancer (nâ¯=â¯11), borderline ovarian tumor (nâ¯=â¯3), early-stage ovarian cancer (nâ¯=â¯1), stage IA cervical cancer after diagnostic conization (nâ¯=â¯1), and an ovarian cyst that turned out to be benign at final histologic examination (nâ¯=â¯1).INTERVENTIONS:
We evaluated all consecutive women scheduled to have laparoscopic procedures for suspected or documented gynecologic cancers. The patients underwent planned laparoscopic surgery. At the end of the laparoscopic procedures (after extubation), we performed reverse transcription-polymerase chain reaction (RT-PCR) tests for the detection of SARS-CoV-2 from both the endotracheal tube and the filter applied on the trocar valve. MEASUREMENTS AND MAINRESULTS:
In 1 patient, both swab tests (endotracheal tube and trocar valve filter) showed amplification of the N gene on RT-PCR analysis. This case was considered to be a presumptive positive case. In another case, the RT-PCR analysis showed an amplification curve for the N gene only in the swab test performed on the filter. No ORF1ab amplification was detected.CONCLUSION:
Our study suggested the proof of principle that SARS-CoV-2 might be transmitted through surgical smoke and aerosolized native fluid from the abdominal cavity.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Laparoscopy
/
COVID-19
Type of study:
Cohort study
/
Diagnostic study
/
Experimental Studies
/
Observational study
/
Prognostic study
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Middle aged
Language:
English
Journal:
J Minim Invasive Gynecol
Journal subject:
Gynecology
Year:
2021
Document Type:
Article
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