Laparoscopic Surgery in the Era of COVID 19
Fri - May 29, 2020
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.
Laparoscopic Surgery During COVID19
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:
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.
- Electrosurgical devices employed
- Low gas motility of pneumoperitoneum
- Gas expulsion through ports or trocars
- Viral dissemination through aerosol droplets
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.