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J. Gastrointest. Surg. · Jul 2020
ReviewWhat Is the Appropriate Use of Laparoscopy over Open Procedures in the Current COVID-19 Climate?
- Yalini Vigneswaran, Vivek N Prachand, Mitchell C Posner, Jeffrey B Matthews, and Mustafa Hussain.
- Department of Surgery, University of Chicago Medical Center, 5841 S. Maryland, Rm. G-210, Chicago, IL, 60637, USA. yvigneswaran@surgery.bsd.uchicago.edu.
- J. Gastrointest. Surg. 2020 Jul 1; 24 (7): 1686-1691.
IntroductionAmong surgeons worldwide, a concern with the use of minimally invasive techniques has been raised due to a proposed risk of viral transmission of the coronavirus disease of 2019 (COVID-19) with the creation of pneumoperitoneum. Due to this proposed concern, we sought to collect the available data and evaluate the use of laparoscopy and the risk of COVID-19 transmission.MethodsA literature review of viral transmission in surgery and of the available literature regarding the transmission of the COVID-19 virus was performed. We additionally reviewed surgical society guidelines and recommendations regarding surgery during this pandemic.ResultsFew studies have been performed on viral transmission during surgery, but to date there is no study that demonstrates or can suggest the ability for a virus to be transmitted during surgical treatment whether open or laparoscopic. There is no societal consensus on limiting or restricting laparoscopic or robotic surgery; however, there is expert consensus on the modification of standard practices to minimize any risk of transmission.ConclusionsDespite very little evidence to support viral transmission through laparoscopic or open approaches, we recommend making modifications to surgical practice such as the use of smoke evacuation and minimizing energy device use among other measures to minimize operative staff exposure to aerosolized particles.
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