Emergency Abdominal Laparoscopic Surgery During the Coronavirus Disease 2019 Pandemic: Experience in a Private Center in Peru.

Background: During the Health Emergency due to coronavirus disease 2019 (COVID-19) in Peru, elective surgeries were suspended and only emergency surgeries were allowed. Conservative management was considered as an alternative and laparoscopic surgery was indicated following safety recommendations. Surgically operated patients were at higher risk of becoming infected with COVID-19 due to hospital exposure, being more susceptible to complications. Methods: Retrospective cohort-type analytical study that includes patients who were admitted to a private center due to an emergency and who underwent laparoscopic gastrointestinal surgery during the National Health Emergency (group exposed to the COVID-19 pandemic) from March 11, 2020 to June 8, 2020 and were compared with those patients operated between March 11, 2019 and June 8, 2019 (group not exposed to the COVID-19 pandemic). Results: A total of 104 patients were identified, 59 patients operated during the COVID-19 pandemic. All were operated by laparoscopy, both groups with a similar degree of disease severity. There was no mortality or surgical reintervention. No surgeon at the institution was infected with the virus during the study period. Conclusions: The degree of severity of abdominal surgical pathologies in this time of pandemic has not increased compared with the previous year. Likewise, the laparoscopic approach to emergency surgery was safe and effective during the pandemic.

La hernia inguinal en la era laparoscópica / Inguinal hernia in the laparoscopic age

Objetivo: Describir los resultados de 327 reparaciones via laparoscópica de hernia inguinal. Material y métodos: Estudio descriptivo de 327 reparaciones vía laparoscópica de hernias inguinales practicadas en 257 pacientes, realizadas entre 1992 y 1996 en el Servicio de Cirugia de American British Cowdray Medical Center, en México distrito federal. Resultados: El sexo fue predominantemente masculino (77.4 por ciento); las edades oscilaron entre 9 y 89 años. En 85 pacientes se trató de hernia inguinal bilateral y de ellas se trataron en 35 casos según la técnica de Stoppa. Tres de los casos de desarrollaron como cirugía de urgencia por el compromiso intestinal concomitante. Las complicaciones presentaron el 8.8 por ciento y se resolvieron espontáneamente; constituidas por meralgia parestésica, retención urinaria, hematomas inguino escrotales. Las decidivas constituyeron el 1.2 por ciento. Conclusiones: Los autores establecen el manejo de las hernias bajo una propuesta de clasificación laparoscópica de los defectos hernianos basada en la de Nyhus.