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Practice Guideline
. 2020 Jun;34(6):2327-2331.
doi: 10.1007/s00464-020-07565-w. Epub 2020 Apr 22.

SAGES and EAES Recommendations for Minimally Invasive Surgery During COVID-19 Pandemic

Free PMC article
Practice Guideline

SAGES and EAES Recommendations for Minimally Invasive Surgery During COVID-19 Pandemic

Nader Francis et al. Surg Endosc. .
Free PMC article


The unprecedented pandemic of COVID-19 has impacted many lives and affects the whole healthcare systems globally. In addition to the considerable workload challenges, surgeons are faced with a number of uncertainties regarding their own safety, practice, and overall patient care. This guide has been drafted at short notice to advise on specific issues related to surgical service provision and the safety of minimally invasive surgery during the COVID-19 pandemic. Although laparoscopy can theoretically lead to aerosolization of blood borne viruses, there is no evidence available to confirm this is the case with COVID-19. The ultimate decision on the approach should be made after considering the proven benefits of laparoscopic techniques versus the potential theoretical risks of aerosolization. Nevertheless, erring on the side of safety would warrant treating the coronavirus as exhibiting similar aerosolization properties and all members of the OR staff should use personal protective equipment (PPE) in all surgical procedures during the pandemic regardless of known or suspected COVID status. Pneumoperitoneum should be safely evacuated via a filtration system before closure, trocar removal, specimen extraction, or conversion to open. All emergent endoscopic procedures performed during the pandemic should be considered as high risk and PPE must be used by all endoscopy staff.

Keywords: COVID-19; Laparoscopy; Surgery.

Conflict of interest statement

Nader Francis, Jonathan Dort, Eugene Cho, Liane Feldman, Deborah Keller, Rob Lim, Dean Mikami, Edward Phillips, Konstantinos Spaniolas, Shawn Tsuda, Kevin Wasco, Tan Arulampalam, Markar Sheraz, Salvador Morales, Andrea Pietrabissa, Horacio Asbun, and Aurora Pryor have no conflicts of interest or financial ties to disclose.


Fig. 1
Fig. 1
Infographic illustration of SAGES/EAES recommendations for COVID-19 and surgery

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