World Journal of Laparoscopic Surgery

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VOLUME 15 , ISSUE 2 ( May-August, 2022 ) > List of Articles

Original Article

Resuming Elective Laparoscopic Surgery during COVID-19 Pandemic: Our Experience and Challenges Faced

Apoorv Goel, Roli Bansal, Shyam Kothari, C Deva Rahul, VB Jindal, Aman Mathur

Keywords : COVID-19 pandemic, Minimal invasive surgery, SARS-CoV-2

Citation Information : Goel A, Bansal R, Kothari S, Rahul CD, Jindal V, Mathur A. Resuming Elective Laparoscopic Surgery during COVID-19 Pandemic: Our Experience and Challenges Faced. World J Lap Surg 2022; 15 (2):145-148.

DOI: 10.5005/jp-journals-10033-1507

License: CC BY-NC 4.0

Published Online: 16-08-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Background: SARS-CoV-2 virus infection was detected and discovered in Wuhan, China, in December 2019, and it was declared a pandemic by WHO in March 2020. Since then a lot of changes were noticed in surgical practice. Various recommendations were released by eminent surgical associations all over the world. This study was designed to study and analyze the findings and experience after resuming elective minimal invasive surgery during the pandemic. Materials and methods: This observational study was conducted at St Joseph's Hospital, Ghaziabad, from May 2020 to May 2021. Various preoperative and postoperative findings were noticed and analyzed. The presence of SARS-CoV-2 virus was also analyzed in endotracheal aspirate and surgical smoke. Observation and results: A total of 287 cases underwent surgery. Most commonly performed surgery was laparoscopic cholecystectomy. The positivity rate for SARS-CoV-2 during preoperative work-up was 2.87%. Slightly more than 5% of cases in postoperative period had COVID-19-like symptoms. None of those patients were found positive on RT-PCR, and X-ray/CT findings were also suggestive of early postoperative changes only. Presence of SARS-CoV-2 virus was not detected in either endotracheal aspirate or surgical smoke. Neither surgery team nor OT staff had infection during this period. There was no mortality, and only 1 patient was found to be infected 2 weeks after discharge. Conclusion: Minimal invasive surgery for elective cases can be safely performed by taking precautions like PPE and smoke evacuation system during the COVID-19 pandemic. There is no evidence of transmission of infection through endotracheal aspirate or surgical smoke.

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  1. General Office of National Health and Family Planning Commission of the People's Republic of China, Office of National Administration of Traditional Chinese Medicine. Diagnosis and treatment of novel coronavirus pneumonia (version 6th). [EB/OL].2020- 02-19.
  2. Li LQ, Huang T, Wang YQ, et al. COVID-19 patients’ clinical characteristics, discharge rate and fatality rate of meta-analysis. J Med Virol 2020;92(6):577–583. DOI: 10.1002/jmv.25757.
  3. Guo YR, Cao QD, Hong ZS, et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak - an update on the status. Mil Med Res 2020;7(1):11. DOI: 10.1186/s40779-020-00240-0.
  4. Zheng MH, Boni L, Fingerhut A. Minimally invasive surgery and the novel coronavirus outbreak: lessons learned in China and Italy. Ann Surg 2020;272(1):e5–e6. DOI: 10.1097/SLA.0000000000003924.
  5. Manzia TM, Angelico R, Parente A, et al. Global management of a common, underrated surgical task during the COVID-19 pandemic: Gallstone disease - an international survey. Ann Med Surg (Lond) 2020;57:95–102. DOI: 10.1016/j.amsu.2020.07.021.
  6. Angioni S. Laparoscopy in the coronavirus disease 2019 (COVID-19) era. Gynecol Surg 2020;17(1):3. DOI: 10.1186/s10397-020-01070-7.
  7. Al-Omar K, Bakkar S, Khasawneh L, et al. Resuming elective surgery in the time of COVID-19: a safe and comprehensive strategy. Updates Surg 2020;72(2):291–295. DOI: 10.1007/s13304-020-00822-6.
  8. Maldonado-Marcos E, Caula-Freixa C, Planellas-Giné P, et al. Impact of SARS-CoV-2 pandemic on elective and emergency surgery in a university hospital. Cir Esp (Engl Ed) 2021;99(5):368–373. DOI: 10.1016/j.ciresp.2020.07.013.
  9. Gupta N, Agrawal H. COVID 19 and laparoscopic surgeons, the Indian scenario – Perspective. Int J Surg 2020;79:165–167. DOI: 10.1016/j.ijsu.2020.05.076.
  10. Francis N, Dort J, Cho E, et al. SAGES and EAES recommendations for minimally invasive surgery during COVID-19 pandemic. Surg Endosc 2020;34(6):2327–2331. DOI: 10.1007/s00464-020-07565-w.
  11. Shabbir A, Menon RK, Somani J, et al. ELSA recommendations for minimally invasive surgery during a community spread pandemic: a centered approach in Asia from widespread to recovery phases. Surg Endosc 2020;34(8):3292–3297. DOI: 10.1007/s00464-020-07618-0.
  12. Thomas V, Maillard C, Barnard A, et al. International Society for Gynecologic Endoscopy (ISGE) guidelines and recommendations on gynecological endoscopy during the evolutionary phases of the SARS-CoV-2 pandemic. Eur J Obstet Gynecol Reprod Biol 2020;253:133–140. DOI: 10.1016/j.ejogrb.2020.08.039.
  13. Cheruiyot I, Sehmi P, Ngure B, et al. Laparoscopic surgery during the COVID-19 pandemic: detection of SARS-CoV-2 in abdominal tissues, fluids, and surgical smoke. Langenbecks Arch Surg 2021;406(4):1007–1014. DOI: 10.1007/s00423-021-02142-8.
  14. Mintz Y, Arezzo A, Boni L, et al. The risk of COVID-19 transmission by laparoscopic smoke may be lower than for laparotomy: a narrative review. Surg Endosc 2020;34(8):3298–3305. DOI: 10.1007/s00464-020-07652-y.
  15. Kwak HD, Kim SH, Seo YS, et al. Detecting hepatitis B virus in surgical smoke emitted during laparoscopic surgery. Occup Environ Med 2016;73(12):857–863. DOI: 10.1136/oemed-2016-103724.
  16. Sawchuk WS, Weber PJ, Lowy DR et al. Infectious papillomavirus in the vapor of warts treated with carbon dioxide laser or electrocoagulation: detection and protection. J Am Acad Dermatol 1989;21(1):41–49. DOI: 10.1016/s0190-9622(89)70146-8.
  17. Johnson GK, Robinson WS. Human immunodeficiency virus-1 (HIV-1) in the vapors of surgical power instruments. J Med Virol 1991;33(1):47–50. DOI: 10.1002/jmv.1890330110.
  18. Chadi SA, Guidolin K, Caycedo-Marulanda A, et al. Current evidence for minimally invasive surgery during the COVID-19 pandemic and risk mitigation strategies: a narrative review. Ann Surg 2020;272(2):e118–e124. DOI: 10.1097/SLA.0000000000004010.
  19. Serban D, Smarandache CG, Tudor C, et al. Laparoscopic surgery in COVID-19 era-safety and ethical issues. Diagnostics (Basel) 2020;10(9):673. DOI: 10.3390/diagnostics10090673.
  20. Bhattacharjee HK, Chaliyadan S, Verma E, et al. Coronavirus disease 2019 and laparoscopic surgery in resource-limited settings. Asian J Endosc Surg 2021;14(2):305–308. DOI: 10.1111/ases.12835.
  21. Mowbray NG, Ansell J, Horwood J, et al. Safe management of surgical smoke in the age of COVID-19. Br J Surg 2020;107(11):1406–1413. DOI: 10.1002/bjs.11679.
  22. Singh P, Bhandoria G, Maheshwari A. Pharmacological prophylaxis and personal protective equipment (PPE) practices in gynecological cancer surgery during COVID-19 pandemic. Indian J Gynecol Oncol 2021;19(1):19. DOI: 10.1007/s40944-021-00500-4.
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