How to manage smoke evacuation and filter pneumoperitoneum during laparoscopy to minimize potential viral spread: different methods from SoMe ‐ a video vignette

Pata, Francesco; García-Granero, Álvaro; Pellino, Gianluca; Pascual‐Miguelañez, Isabel; Alvarez‐Gallego, Mario; Ruiz, Manuel Losada; Hernández-García, Miguel; Fernández, Beatriz Diéguez; Rodríguez, A. Vaquero; Poza, Alfredo Alonso; Benítez, Carlos Yáñez; Montalbán, Beatriz Cros; Pedival, Ana NoguEs; Laína, Juan Luis Blas; Virosta, Mariana García; López, Daniel Sánchez; Vigorita, Vincenzo; Pereira, André; Iribarren, Enrique Moncada; Santos, Raquel Sánchez; Izquierdo, Julià Diez; Sánchez, Félix López; Pecharroman, Esther Cano; Duque, Teresa Calderon; Buleje, Jorge Alejandro Benavides; Sanz, Núria; Morales, Pedro López; Ros, Emilio; Baños, Pedro Antonio Parra; Spinelli, Antonino; Carrano, Francesco Maria; Henere, D. Costa; Fonollosa, Eric Herrero; Molina‐Romero, Francesc Xavier; Pujol-Cano, Natalia; Palma‐Zamora, Elías; Canis, José Miguel Morón; González‐Argente, Francesc Xavier

doi:10.1111/codi.15086

Cited by 15 publications

(7 citation statements)

References 2 publications

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“…Current publications have downsized these risks with measures of smoke/aerosol containment and proper smoke evacuation. However, only 26% reported to have purposed design smoke evacuation systems, and almost half had to improvise them using standard filters, and waters seal devices [45], which could be useful for smoke and vapors generated electrosurgical and ultrasonic devices until more evidence-based research in this field is available.…”

Section: Discussionmentioning

confidence: 99%

International cooperation group of emergency surgery during the COVID-19 pandemic

Benítez

Ribeiro

Alexandrino

et al. 2020

Eur J Trauma Emerg Surg

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Purpose The COVID-19 pandemic has changed working conditions for emergency surgical teams around the world. International surgical societies have issued clinical recommendations to optimize surgical management. This international study aimed to assess the degree of emergency surgical teams' adoption of recommendations during the pandemic. Methods Emergency surgical team members from over 30 countries were invited to answer an anonymous, prospective, online survey to assess team organization, PPE-related aspects, OR preparations, anesthesiologic considerations, and surgical management for emergency surgery during the pandemic. Results One-hundred-and-thirty-four questionnaires were returned (N = 134) from 26 countries, of which 88% were surgeons, 7% surgical trainees, 4% anesthetists. 81% of the respondents got involved with COVID-19 crisis management. Social media were used by 91% of the respondents to access the recommendations, and 66% used videoconference tools for team communication. 51% had not received PPE training before the pandemic, 73% reported equipment shortage, and 55% informed about re-use of N95/FPP2/3 respirators. Dedicated COVID operating areas were cited by 77% of the respondents, 44% had performed emergency surgical procedures on COVID-19 patients, and over half (52%), favored performing laparoscopic over open surgical procedures. Conclusion Surgical team members have responded with leadership to the COVID-19 pandemic, with crisis management principles. Social media and videoconference have been used by the vast majority to access guidelines or to communicate during social distancing. The level of adoption of current recommendations is high for organizational aspects and surgical management, but not so for PPE training and availability, and anesthesiologic considerations.

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Section: Discussionmentioning

confidence: 99%

International cooperation group of emergency surgery during the COVID-19 pandemic

Benítez

Ribeiro

Alexandrino

et al. 2020

Eur J Trauma Emerg Surg

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“…Also, adequate precautions must be adopted, using ultrafiltration (smoke evacuators and/or filters) during the procedure and monitoring smoke/ gas evacuation and final exsufflation. Trocar incisions should be minimized, using trocars with balloon to avoid gas leakage around ports [17].…”

Section: Discussionmentioning

confidence: 99%

Minimal invasive surgery for left colectomy adapted to the COVID‐19 pandemic: laparoscopic intracorporeal resection and anastomosis, a ‘don’t touch the bowel’ technique

et al. 2021

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Aim The COVID‐19 pandemic has forced surgeons to adapt their standard procedures. The modifications introduced are designed to favour minimally invasive surgery. The positive results obtained with intracorporeal resection and anastomosis in the right colon and rectum prompt us to adapt these procedures to the left colon. We describe a ‘don't touch the bowel’ technique and outline the benefits to patients of the use of less surgically aggressive techniques and also to surgeons in terms of the lower emission of aerosols that might transmit the COVID‐19 infection. Methods This was an observational study of intracorporeal resection and anastomosis in left colectomy. We describe the technical details of intracorporeal resection, end‐to‐end stapled anastomosis and extraction of the specimen through mini‐laparotomy in the ideal location. Results We present preliminary results of 17 patients with left‐sided colonic pathologies, 15 neoplasia and two diverticular disease, who underwent four left hemicolectomies, six sigmoidectomies and seven high anterior resections. Median operating time was 186 min (range 120–280). No patient required conversion to extracorporeal laparoscopy or open surgery. Median hospital stay was 4.7 days (range 3–12 days). There was one case of anastomotic leak managed with conservative treatment. Conclusion Intracorporeal resection and end‐to‐end anastomosis with the possibility of extraction of the specimen by a mini‐laparotomy in the ideal location may present benefits and also adapts well to the conditions imposed by the COVID‐19 pandemic. Future comparative studies are needed to demonstrate these benefits with respect to extracorporeal anastomosis.

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“…During the early period of the COVID-19 pandemic, various measures to manage smoke during laparoscopic surgery were reported [ 10 ]. However, these measures were not practical in most hospital environments.…”

Section: Does Smoke Matter In the Transmission Of Sars-cov-2 During T...mentioning

confidence: 99%

Does surgical smoke matter?

Lee

2021

J Minim Invasive Surg

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The coronavirus disease 2019 (COVID-19) pandemic has dramatically changed our daily lives and medical practices since it was first reported in December 2019 in Wuhan, China. Unlike the usual transmission patterns of other viral diseases, the asymptomatic or presymptomatic transmission of COVID-19 has caused difficulties in disease control around the globe. Surgical smoke or fumes may carry viruses. However, there is no evidence that the severe acute respiratory syndrome coronavirus 2, which causes COVID-19, is transmitted via surgical smoke or fumes. Laparoscopic surgeries should be continued to ensure optimal patient care. This review article aimed to investigate the current evidence relating to COVID-19 in surgical care and to discuss future remedies as the COVID-19 pandemic continues.

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How to manage smoke evacuation and filter pneumoperitoneum during laparoscopy to minimize potential viral spread: different methods from SoMe ‐ a video vignette

Cited by 15 publications

References 2 publications

International cooperation group of emergency surgery during the COVID-19 pandemic

International cooperation group of emergency surgery during the COVID-19 pandemic

Minimal invasive surgery for left colectomy adapted to the COVID‐19 pandemic: laparoscopic intracorporeal resection and anastomosis, a ‘don’t touch the bowel’ technique

Does surgical smoke matter?

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