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Laparoscopic Surgery in the Era of COVID 19
Fri - May 29, 2020 6:10 am  |  Article Hits:3621  |  A+ | a-
Laparoscopic Surgery During COVID19
Laparoscopic Surgery During COVID19
Laparoscopy is surgery’s biggest boons to patients owing to smaller incisions, lesser blood loss, less pain, less infection, and reduced post-operative hospitalization while minimizing pain, have run into a giant speed-breaker, and are staring at their biggest challenge to date: Covid-19.

Most elective minimal access surgical procedures that utilization the insignificantly intrusive strategy have been uncertainly deferred. What's more, techniques considered pressing are tightrope strolls for OT professionals gauging the dangers of offsetting careful exactness with shielding staff from infection of the coronavirus. Laparoscopic procedures that put helping staff or careful clean attendants in danger have additionally been halted for the occasion.

Precautions to be taken by surgeons have become very important lowering pressure during intubation, filtration to evacuate smoke, and avoiding energy sources that will generate more smoke. Of course, there’s no compromising on N95 masks and PPE for everyone in the OT.

Higher concentrations of particulate matter. Laparoscopic surgery produces more particulate matter than open surgery, increasing the risk of viral transmission. The high particulate matter is mostly attributed to:
  • Electrosurgical devices employed
  • Low gas motility of pneumoperitoneum
  • Gas expulsion through ports or trocars
  • Viral dissemination through aerosol droplets
Creating a pneumoperitoneum is an essential step in laparoscopic surgery. However, pneumoperitoneum-associated aerosolization of particles raises the concerns regarding the risk of dissemination of SARS-CoV-2 during minimally invasive surgery. Particles in surgical smoke contain a variety of toxic and virulent materials that can cause infection through inhalation. A similar outbreak of SARS-CoV-1 in 2002–2003 was associated with nosocomial transmission through aerosol droplets.

N96 Surgical Mask

Electrosurgical smoke contains potentially hazardous organic and inorganic compounds including Nobel Coronavirus if the patient is affected by this disease; the researchers of one study found the amount of surgical smoke produced in a laparoscopic surgery operating theatre is equivalent to 27 to 30 cigarettes said, Dr. R.K. Mishra. Bacteria and viruses can be transmitted through this smoke. The topic of electrosurgical smoke is important to occupational health nurses not only because of their responsibility to protect workers but also because they, like surgeons, may be exposed to smoke routinely.

A laparoscopic Smoke Evacuation System is also necessary. According to Dr. Mishra, the Smoke Evacuation System is an easy-to-use device, that connects to a standard Luer-lock trocar and a suction or vacuum unit. When used during laparoscopic procedures, it will effectively and efficiently remove smoke, from the peritoneal cavity. So, the surgeon can have enhanced visualization of the surgical site safety from COVID 19 and Improved air quality in the. Therefore, the whole surgical team should wear personal protection equipment including
  • Use of Laparoscopic Smoke Evacuation System
  • Disposable surgical caps
  • Medical protective mask (N95)
  • Surgical shield uniform
  • Disposable medical protective uniform
  • Disposable latex gloves
  • Full-face respiratory protective devices
  • Powered air-purifying respirator

Laparoscopic surgery during a pandemic comes with multiple threats for the surgical team. Therefore, it is crucial to take measures for the safeguard of colleagues, family, and friends. Although these measures are going to increase the cost of surgery for the well being of health professionals this is necessary.

Introduction

Laparoscopic surgery has become a popular choice for many surgical procedures due to its minimally invasive nature, which offers several advantages over traditional open surgery. However, the emergence of the COVID-19 pandemic has presented new challenges for laparoscopic surgery, as healthcare providers must balance the benefits of minimally invasive surgery with the risk of COVID-19 transmission. This essay will explore how laparoscopic surgery has been affected by the COVID-19 pandemic and what measures have been taken to ensure safe and effective surgery during this time.

Impact of COVID-19 on Laparoscopic Surgery

The COVID-19 pandemic has had a significant impact on the practice of laparoscopic surgery. One of the primary concerns with laparoscopic surgery during the pandemic is the risk of COVID-19 transmission from infected patients to healthcare providers. Laparoscopic surgery involves the use of insufflation, which creates a cloud of gas in the surgical field that can potentially carry viral particles. Additionally, laparoscopic surgery often generates aerosols, which can also potentially transmit the virus.

To address these concerns, healthcare providers have had to adopt new safety measures for laparoscopic surgery during the pandemic. These measures include:

Personal Protective Equipment (PPE)

Healthcare providers performing laparoscopic surgery during the pandemic must wear appropriate PPE, including masks, face shields, gowns, and gloves. This PPE helps to reduce the risk of COVID-19 transmission from infected patients to healthcare providers.

COVID-19 Testing

Healthcare providers must also ensure that patients undergoing laparoscopic surgery are tested for COVID-19 prior to the procedure. This helps to identify infected patients and reduce the risk of COVID-19 transmission during surgery.

Social Distancing

To reduce the risk of COVID-19 transmission during laparoscopic surgery, healthcare providers must also implement social distancing measures in the operating room. This may include reducing the number of people present during surgery and maintaining appropriate distances between healthcare providers.

Minimizing Aerosols

Healthcare providers must also take steps to minimize the generation of aerosols during laparoscopic surgery. This may include using smoke evacuators and minimizing the use of electrocautery, which can generate aerosols.

Benefits of Laparoscopic Surgery During the Pandemic

Despite the challenges presented by the COVID-19 pandemic, laparoscopic surgery still offers several benefits over traditional open surgery. These benefits include:

Shorter Hospital Stays

Laparoscopic surgery is typically associated with shorter hospital stays than traditional open surgery. This can reduce the risk of COVID-19 transmission in hospitals by minimizing the amount of time patients spend in healthcare facilities.

Less Pain and Complications

Laparoscopic surgery is also associated with less pain and fewer complications than traditional open surgery. This can reduce the need for follow-up care and minimize the risk of COVID-19 transmission associated with additional hospital visits.

Faster Recovery Times

Laparoscopic surgery is typically associated with faster recovery times than traditional open surgery. This can help to reduce the burden on healthcare facilities during the COVID-19 pandemic by freeing up hospital beds and reducing the need for long-term care.

In addition to the safety measures already mentioned, there are other ways that laparoscopic surgery has adapted to the challenges of the COVID-19 pandemic. Telemedicine has become increasingly popular for preoperative and postoperative consultations, reducing the need for in-person visits and minimizing the risk of COVID-19 transmission. Healthcare providers have also worked to optimize their surgical schedules, prioritizing urgent procedures and delaying non-urgent procedures when possible to minimize the number of patients in hospitals and reduce the risk of COVID-19 transmission.

There have also been innovations in laparoscopic surgery during the COVID-19 pandemic. For example, some surgeons have used virtual reality technology to simulate surgical procedures, allowing them to practice and refine their skills without putting themselves or patients at risk of COVID-19 transmission. Additionally, robotic-assisted laparoscopic surgery has become increasingly popular, as it allows for greater precision and control during surgery, reducing the risk of complications and improving patient outcomes.

It is important to note that laparoscopic surgery is not always an option for every patient, and some surgical procedures may still require traditional open surgery. Healthcare providers must carefully evaluate each patient and determine the most appropriate surgical approach based on their individual needs and circumstances.

Conclusion

The COVID-19 pandemic has presented new challenges for laparoscopic surgery, but healthcare providers have adapted to ensure safe and effective surgery during this time. By implementing appropriate safety measures, such as PPE, COVID-19 testing, social distancing, and minimizing aerosols, healthcare providers can continue to offer the benefits of laparoscopic surgery while minimizing the risk of COVID-19 transmission. Laparoscopic surgery still offers several advantages over traditional open surgery, including shorter hospital stays, less pain and complications, and faster recovery times. As the pandemic continues, healthcare providers will need to continue to adapt and innovate to ensure that laparoscopic surgery remains a safe and effective option for patients in need of surgical procedures.

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World Laparoscopy Hospital
Cyber City
Gurugram, NCR Delhi, 122002
India

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