Laparoscopic surgery does not increase the risk of contagion of COVID-19 for healthcare personnel
The current coronavirus disease pandemic has had a major impact on the healthcare system, and epidemiologists have shown that the risk of mortality when treating infectious diseases is higher if medical personnel work under pressure. For this reason, it is essential to minimize the risk of contagion in the case of professionals who must treat patients affected by COVID-19. In this regard, it is worrisome that some interventions, such as laparoscopic surgery, pose a greater risk of contagion compared to open surgeries.
For this reason, a group of researchers from various centers, including Dr Pere Barri Soldevila, coordinator of the Surgical Section and Director of the Dexeus Mujer Department, has carried out a review of the scientific literature in order to describe the possible routes of contamination and the risks of contagion to which the personnel who provide medical care may be exposed, and has also collected the opinion of experts on the performance of laparoscopic surgery in patients infected by COVID-19. The investigation was carried out from the information that appears in the databases of PubMed, CINAHL, and Embase, adding to these the results of other scientific reports. The investigation also included not only data related to COVID-19 but also data from other studies on viral contamination.
In total, 267 full-text articles were collected. Finally, 84 articles were used, of which 14 addressed the topic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Eight articles evaluated the added value of performing intubation in a low-pressure operating room, mainly based on the experience of the SARS outbreak in 2003. Thirteen articles detailed the risks of intubation for healthcare providers and SARS-CoV-2 , and 19 articles studied this same situation with other viral agents.
The results show that intubation and extubation are high-risk procedures for health professionals and that a team is needed that provides maximum protection in these cases. On the other hand, there is little evidence in relation to the real risk of contagion of health professionals during the laparoscopy itself, and also in relation to the positive pressure in the operating room, the smoke produced in surgery, the C02 that comes out of the abdomen when the trocars or when extracting parts. However, new studies are published every day so these observations may change. However, there appears to be no reason to abandon laparoscopic surgery in favor of open surgery. However, the risks should not be underestimated, which is why the authors conclude that surgery should be performed in patients with COVID-19 only when necessary, and healthcare providers should ensure the greatest protection in these cases, both for themselves and for the rest of the team, and perform the surgery in a safe and secure environment.
JMIR Public Health Surveill; 2020 Jun 23;6(2):e18928. doi: 10.2196/18928