Laparoscopic Gastrointestinal Surgery During COVID-19 Pandemic: Single-Center Experience

J Laparoendosc Adv Surg Tech A. 2021 Apr;31(4):455-457. doi: 10.1089/lap.2020.0481. Epub 2020 Aug 24.

Abstract

Background: COVID-19 era has put laparoscopic surgery a risk procedure because of theoretical risk of viral transmission of COVID-19. However, safe evacuation of stagnant air during laparoscopic surgery is also necessary to safeguard health care warriors. Methods: We are reporting experience of 24 laparoscopic surgeries using a closed smoke evacuation/filtration system using a ultra low-particulate air (ULPA) filtration capability (ConMed AirSeal® System) at a single center between March 22, 2020, and May 30, 2020. All surgeries were either urgent or emergency in nature. Results: Totally, 17 males and 7 females who required urgent surgery. Most common indication for laparoscopic intervention was acute cholecystitis and complications related to acute cholecystitis. Owing to the closed smoke evacuation system, low intra-abdominal pressure was maintained during all surgeries. Of all procedures, only 0.8 time per procedure, the laparoscope taken out for cleaning. Mean time for completion of surgery was 58 minutes. Compliance of surgical staff was high due to the deemed safe smoke evacuation system. Mean of postoperative pain score was low. Mean hospital stay was 4.9 days. Conclusions: We propose to use a closed smoke evacuation/filtration system with ULPA filtration capability or similar devices in each minimally invasive surgery to reduce risks of transmission as minute as possible until we have enough knowledge about the pattern of disease transmission.

Keywords: COVID-19 pandemic; laparoscopic surgery; smoke evacuation.

Publication types

  • Observational Study

MeSH terms

  • COVID-19 / prevention & control*
  • Cholecystitis, Acute / complications
  • Cholecystitis, Acute / surgery
  • Digestive System Surgical Procedures / adverse effects
  • Digestive System Surgical Procedures / instrumentation*
  • Emergencies
  • Female
  • Health Personnel*
  • Humans
  • Laparoscopy / adverse effects
  • Laparoscopy / instrumentation*
  • Length of Stay
  • Male
  • Middle Aged
  • Occupational Exposure / prevention & control*
  • Operating Rooms
  • Operative Time
  • Pain, Postoperative / etiology
  • Pneumoperitoneum, Artificial
  • SARS-CoV-2