EP.WE.238Implications of COVID-19 on Laparoscopic General Surgery: a single site experience

Abstract

Introduction and Aims The COVID-19 pandemic has had an unprecedented impact on service provision in Emergency General Surgery. Due to the unknown risk of COVID-19 transmission, the use of laparoscopic surgery was cautioned against in favour of open surgery or conservative management. This study looks at the impact of service reconfiguration on rates of laparoscopic surgery. Methods The management and outcomes were audited of all patients admitted to our unit during the UK COVID-19 lockdown period and compared against the same period last year. Results In total, 645 patients (223 COVID-19 period, 422 non-COVID) were included. Less surgery was performed during the pandemic (32.3% vs 39.3%), with only 2 cases of laparoscopic surgery (0.9% vs 16.1%). Despite a change to conservative management, we report no differences in complication rates or length of stay and 30-day mortality (excluding deaths from COVID-19 pneumonitis). Re-admission rates were higher following conservative management (10.6% vs 4.7%). Conclusion There is a significant reduction in surgery (particularly laparoscopic surgery) during the COVID-19 pandemic. There are no differences in outcomes, but we show higher re-admission rates for patients treated conservatively. Together with emerging evidence on the safety of laparoscopic surgery, these findings help inform service re-configuration for future pandemic responses.