Practical recommendations for gynecologic surgery during the COVID-19 pandemic

Int J Gynaecol Obstet. 2020 May 29. doi: 10.1002/ijgo.13248. Online ahead of print.

Abstract

Surgery in suspected/confirmed COVID-19 patients is a high-risk venture. In infected patients, COVID-19 is present in the body cavity. During surgery it could be nebulized in the spray generated by surgical instruments and could theoretically infect members of the surgical team. Nevertheless, some surgical gynecologic pathologies cannot be postponed. We present a list of the most frequent gynecologic diseases and recommendations on their surgical management during the COVID-19 pandemic, based on expert opinion, current available information, and international scientific society recommendations to support the work of gynecologists worldwide. In brief, any kind of surgical treatment should be scrutinized and postponed if possible. Nonoperative conservative treatment including pharmacological therapies for hormone-sensitive pathologies should be implemented. Health risk assessment by patient history and COVID-19 test before elective surgery are pivotal to protect both patients and healthcare providers. In confirmed COVID-19 patients or highly suspected cases, elective surgery should be postponed until full recovery.

Keywords: COVID-19; Cervical cancer; Coronavirus; Endometrial cancer; Endometriosis; Gynecology; Laparoscopy; Myoma; Ovarian cancer; Surgery; Urogynecology; Vulvar cancer.

Publication types

  • Review