Expert consensus from the Italian Society for Colposcopy and Cervico‐Vaginal Pathology (SICPCV) for colposcopy and outpatient surgery of the lower genital tract during the COVID‐19 pandemic

Abstract

In the context of the COVID-19 pandemic, patients need to be evaluated within 2-4 weeks in the following cases: cytology result of "squamous cell carcinoma," "atypical glandular cells, favor neoplastic," "endocervical adenocarcinoma in situ," or "adenocarcinoma"; histopathological diagnosis of suspected invasion from cervical/vaginal biopsy, or invasive disease after a cervical excision procedure, vaginal excision, or vulvar biopsy/excision; sudden onset of strongly suggestive symptoms for malignancy. Digital imaging technologies represent an important opportunity during the COVID-19 pandemic to share colposcopic images with reference centers, with the aim of avoiding any concentration of patients. All patients must undergo screening for COVID-19 exposure and should wear a surgical mask. A high-efficiency filter smoke evacuation system is mandatory to remove surgical smoke. Electrosurgical instruments should be set at the lowest possible power and not be used for long continuous periods to reduce the amount of surgical smoke. The following personal protective equipment should be used: sterile fluid-repellant surgical gloves, an underlying pair of gloves, eye protection, FFP3 mask, surgical cap, and gown. The colposcope should be protected by a disposable transparent cover. A protective lens that must be disinfected after each use should be applied. The use of a video colposcope should be preferred. K E Y W O R D S

Personal protective equipment for surgeons during COVID-19 pandemic: systematic review of availability, usage and rationing

“…In general surgery, laparoscopy and endoscopy should be performed only where there is no alternative and laparotomies carried out wearing full PPE 67–70 . Similar changes in guidance have been seen in gynaecology 71,72 , paediatric surgery 73 , urology 74 , orthopaedics 75,76 , head and neck cancer 77 and neurosurgery 78 .…”

European Federation for Colposcopy (EFC) and European Society of Gynaecological Oncology (ESGO) joint considerations about human papillomavirus (HPV) vaccination, screening programs, colposcopy, and surgery during and after the COVID-19 pandemic

“…In that case, evaluation should not be deferred, patients should wear a surgical mask, and all team members should wear appropriate PPE (sterile fluid-repellant surgical gloves, an underlying pair of gloves, eye protection, FFP3 mask, surgical cap, and gown). 2 Asymptomatic women without COVID-19 test results should wear a surgical mask, and staff should wear appropriate PPE (sterile fluid-repellant surgical gloves, eye protection, FFP2 mask, surgical cap, and gown).…”

“…Regarding cervical cancer prevention, including vaccination, screening programs, colposcopy, and outpatient surgery of the lower genital tract as well as follow-up, several societies provided guidance to advise clinicians and service providers on the triage of patients who needed a prompt evaluation in a colposcopy clinic from patients whose care could be safely postponed. 2–6 Those recommendations could be applied in all countries in which screening programs and elective surgery were suspended.…”

Role of digital pathology in diagnostic histopathology in the response to COVID-19: results from a survey of experience in a UK tertiary referral hospital

“…The majority of us have quickly become accustomed to the utility of technology such as videoconferencing during this crisis, and other technologies are opening doors to the opportunity for remote working, protecting the workforce during these challenging times while maintaining clinical services and other aspects of our work such as training and management. 1 Histopathology presents its own specific challenges within this context, partly because there are aspects of the job that simply cannot be done remotely, for example, the handling of surgical and cytology specimens. Reporting of clinical cases on glass slides is possible remotely, necessitating the transportation of the cases, and this is familiar to many histopathologists who have worked flexibly prior to the current crisis.…”