Management strategies and role of telemedicine in a surgery unit during COVID-19 outbreak

Palomba, Giuseppe; Dinuzzi, Vincenza Paola; Palma, Giovanni Domenico De; Aprea, Giovanni

doi:10.1016/j.ijsu.2020.05.081

Cited by 7 publications

(5 citation statements)

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“…“Stay at home” policies such as lockdowns, curfews and social distancing protocols have forced patients to stay away from hospitals and postpone surgical consultations [ 2 , 4 ]. Telemedicine has been reported useful in preoperative and postoperative surgical consultations and has even been used for intraoperative mentoring with successful outcomes for patients [ 5 ]. Despite the reported benefits, most surgeons do not rely on telemedicine advantages and fear to misdiagnose postoperative complications.…”

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confidence: 99%

Telemedicine for postoperative follow-up, virtual surgical clinics during COVID-19 pandemic

et al. 2020

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Summary and background data Recent coronavirus outbreak and “stay at home” policies have accelerated the implementation of virtual healthcare. Many surgery departments are implementing telemedicine to enhance remote perioperative care. However, concern still arises regarding the safety of this modality in postoperative follow-up after gastrointestinal surgery. The aim of the present prospective study is to compare the use of telemedicine clinics to in-person follow-up for postoperative care after gastrointestinal surgery during COVID-19 outbreak. Methods Prospective study that included all abdominal surgery patients operated since the COVID-19 outbreak. On discharge, patients were given the option to perform their postoperative follow-up appointment by telemedicine or by in-person clinics. Demographic, perioperative, and follow-up variables were analyzed. Results Among 219 patients who underwent abdominal surgery, 106 (48%) had their postoperative follow-up using telemedicine. There were no differences in age, gender, ASA score, and COVID-19 positive rate between groups. Patients who preferred telemedicine over in-person follow-up were more likely to have undergone laparoscopic surgery (71% vs. 51%, P = 0.037) and emergency surgery (55% vs. 41%; P = 0.038). Morbidity rate for telemedicine and in-person group was 5.7% and 8%, ( P = 0.50). Only 2.8% of patients needed an in-person visit following the telemedicine consult, and 1.9% visited the emergency department. Conclusions In the current pandemic, telemedicine follow-up can be safely and effectively performed in selected surgical patients. Patients who underwent laparoscopic and emergency procedures opted more for telemedicine than in-person follow-up.

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confidence: 99%

Telemedicine for postoperative follow-up, virtual surgical clinics during COVID-19 pandemic

et al. 2020

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“…This study suffers from several limitations: sample size was limited due to the relative infrequency of adrenal masses, a severe restriction of nonurgent surgical procedures, and limited Intensive Care Unit availability during the COVID-19 pandemic (started in March 2020) greatly hampered patients’ enrollment. 49 ICG may also have limits, such as hepatic fluorescence during right adrenalectomy, hypofluorescence of adrenocortical carcinomas, and very rare cases of anaphylaxis. 11 , 50 Randomized trials need to be carried out for evaluating the role of these methods in LA.…”

Section: Discussionmentioning

confidence: 99%

The Role of Intraoperative Indocyanine Green (ICG) and Preoperative 3-Dimensional (3D) Reconstruction in Laparoscopic Adrenalectomy: A Propensity Score-matched Analysis

Palomba

Dinuzzi

Pegoraro

et al. 2022

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: Laparoscopic adrenalectomy (LA) is considered the "gold standard" treatment of adrenal lesions that are often coincidentally diagnosed during the radiologic workup of other diseases. This study aims to evaluate the intraoperative role of indocyanine green (ICG) fluorescence associated with preoperative 3-dimensional reconstruction (3DR) in laparoscopic adrenalectomy in terms of perioperative outcomes. To our knowledge, this is the first prospective case-controlled report comparing these techniques.Materials and Methods: All consecutive patients aged ≥ 18 and undergoing laparoscopic transperitoneal adrenalectomy for all adrenal masses from January 1, 2019 to January 31, 2022 were prospectively enrolled. Patients undertaking standard LA and those undergoing preoperative 3D reconstruction and intraoperative ICG fluorescence were matched through a one-on-one propensity score matching analysis (PSM) for age, gender, BMI, CCI score, ASA score, lesion histology, tumor side, and lesion diameter. Differences in operative time, blood loss, intraoperative and postoperative complications, conversion rate, and length of stay were analyzed.Results: After propensity score matching analysis, we obtained a cohort of 36 patients divided into 2 groups of 18 patients each. The operative time and intraoperative blood loss were shorter in patients of the 3DR group (P = 0,004 and P = 0,004, respectively). There was no difference in terms of length of stay, conversion rate, and intraoperative and postoperative complications between the 2 groups.Conclusions: The use of intraoperative ICG in LA and preoperative planning with 3DR images is a safe and useful addition to surgery. Furthermore, we observed a reduction in terms of operating time and intraoperative blood loss.

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“…Our unit has an annual volume of 150 cases of robotic procedures for general surgery, and at least 60% of which for colorectal surgery. As part of COVID-19 containment strategy and with Intensive Care Unit (ICU) near collapse, there was a reduction in surgical procedures, including colorectal interventions also due to the decrease in endoscopic diagnoses [ 36 , 37 ]. In this study, we compared laparoscopic and robotic colorectal surgery in elderly patients with colorectal cancer.…”

Section: Discussionmentioning

confidence: 99%

Robotic versus laparoscopic colorectal surgery in elderly patients in terms of recovery time: a monocentric experience

et al. 2021

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Management strategies and role of telemedicine in a surgery unit during COVID-19 outbreak

Cited by 7 publications

References 2 publications

Telemedicine for postoperative follow-up, virtual surgical clinics during COVID-19 pandemic

Telemedicine for postoperative follow-up, virtual surgical clinics during COVID-19 pandemic

The Role of Intraoperative Indocyanine Green (ICG) and Preoperative 3-Dimensional (3D) Reconstruction in Laparoscopic Adrenalectomy: A Propensity Score-matched Analysis

Robotic versus laparoscopic colorectal surgery in elderly patients in terms of recovery time: a monocentric experience

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