Essential Gynecologic Surgery during the COVID-19 Pandemic: New York Institutional Experience

Abstract

Study Objective To report on the continuance of gynecologic surgery during the COVID-19 pandemic. Design Case series. Setting New York City Academic Medical Center. Patients or Participants In Mid-March of 2020 there was a moratorium on elective services due to the COVID-19 pandemic. 105 surgeries were completed from March 15-April 30, and those that were emergent and urgent were identified. Essential gynecologic surgical procedures were provided during the COVID-19 pandemic. Interventions Peri-operative data were collected retrospectively. Measurements and Main Results A total of 45 cases were identified that were emergent and urgent gynecologic surgical procedures during the COVID-19 pandemic in New York City. Average age was 34 years (range 24-68). In our health system, there were 23 emergency gynecologic cases, the most common were ectopic (14), torsion (3), retained products of conception causing hemorrhage (3) or sepsis (1), exploratory laparotomy for post-operative small bowel obstruction (1), and vaginal myomectomy for hemorrhage (1). Pre-operative PCR testing for COVID-19 was available March 31, but emergency cases were not delayed to await test results. Of the emergency cases, 21 (91.3%) were performed with general and 2 (8.7%) with neuraxial anesthesia. There were 21 urgent gynecologic surgical procedures. All surgical procedures recovered in the operating room during this time frame. Conclusion Essential gynecologic surgery can feasibly continue during peak pandemic crisis in high prevalence areas, with appropriate safety measures.

Gynecologic surgery during the COVID-19 pandemic: Patan Hospital experience

“…Pre-operative PCR testing for COVID-19 was available on March 31, but emergency cases were not delayed to await test results. 13 In Brazil, both the National Health Agency (ANS) and National Health Surveillance Agency (ANVISA) advised the postponement of elective and non-essential surgeries, causing a considerable impact on the number of surgical procedures that decreased by 33.4% in this period. 14 In the study for determination of the effect of the pandemic on elective surgical practice, they found a significant reduction in the volume of elective surgical services rendered during April to June 2020 when there were total lockdowns in Nigeria, compared to a corresponding period in the preceding year.…”