Enhancing safety of laparoscopic surgery in COVID-19 era: clinical experience with low-cost filtration devices

Eur J Trauma Emerg Surg. 2020 Aug;46(4):731-735. doi: 10.1007/s00068-020-01413-1. Epub 2020 Jun 1.

Abstract

Background: Surgery in the era of the current COVID-19 pandemic has been curtailed and restricted to emergency and certain oncological indications, and requires special attention concerning the safety of patients and health care personnel. Desufflation during or after laparoscopic surgery has been reported to entail a potential risk of contamination from 2019-nCoV through the aerosol generated during dissection and/or use of energy-driven devices. In order to protect the operating room staff, it is vital to filter the released aerosol.

Methods: The assemblage of two easily available and low-cost filter systems to prevent potential dissemination of Coronavirus via the aerosol is described.

Results: Forty-nine patients underwent laparoscopic surgeries with the use of one of the two described tools, both of which proved to be effective in smoke evacuation, without affecting laparoscopic visualization.

Conclusion: The proposed systems are cost-effective, easily assembled and reproducible, and provide complete viral filtration during intra- and postoperative release of CO2.

Keywords: Coronavirus; Emergency surgery; Laparoscopy; Oncologic surgery; Pneumoperitoneum; Prevention.

MeSH terms

  • Betacoronavirus / isolation & purification
  • COVID-19
  • Coronavirus Infections* / epidemiology
  • Coronavirus Infections* / prevention & control
  • Disease Transmission, Infectious / prevention & control
  • Emergency Medical Services / methods
  • Equipment Design
  • Filtration / methods*
  • Humans
  • Infection Control / methods*
  • Laparoscopy* / adverse effects
  • Laparoscopy* / instrumentation
  • Laparoscopy* / methods
  • Operating Rooms / methods
  • Operating Rooms / trends
  • Pandemics* / prevention & control
  • Pneumonia, Viral* / epidemiology
  • Pneumonia, Viral* / prevention & control
  • Pneumoperitoneum, Artificial / methods
  • SARS-CoV-2
  • Safety Management / methods