Practical recommendations for gynecologic surgery during the COVID‐19 pandemic

Abstract

Surgery in suspected/confirmed COVID‐19 patients is a high‐risk venture. In infected patients, COVID‐19 is present in the body cavity. During surgery it could be nebulized in the spray generated by surgical instruments and could theoretically infect members of the surgical team. Nevertheless, some surgical gynecologic pathologies cannot be postponed. We present a list of the most frequent gynecologic diseases and recommendations on their surgical management during the COVID‐19 pandemic, based on expert opinion, current available information, and international scientific society recommendations to support the work of gynecologists worldwide. In brief, any kind of surgical treatment should be scrutinized and postponed if possible. Nonoperative conservative treatment including pharmacological therapies for hormone‐sensitive pathologies should be implemented. Health risk assessment by patient history and COVID‐19 test before elective surgery are pivotal to protect both patients and healthcare providers. In confirmed COVID‐19 patients or highly suspected cases, elective surgery should be postponed until full recovery.

Impact of COVID-19 on management of urogynaecology patients: a rapid review of the literature

“…Recommendations regarding surgery advise regional or local anaesthesia where possible, in order to reduce aerosol generation with general anaesthesia [ 2 , 19 , 25 , 28 ]. Screening for COVID-19 symptoms and testing preoperatively is advised, as evidence has shown poorer surgical outcomes for asymptomatic COVID-19 patients, therefore surgery may worsen or accelerate progression [ 2 , 4 , 5 , 8 , 14 , 21 , 28 , 30 ]…”

Impact of the COVID-19 Pandemic on the Practice of Hand and Upper Extremity Surgeons

“…[6]. Many medical and surgical societies got together and devised various strategies on how to balance the surgical and safety needs of the patients and, despite constraints, how to best manage their resource allocation and contribute to mitigation efforts in place during the pandemic [7][8][9][10][11][12][13].…”

“…Other researchers have studied the effect of the pandemic on many different specialties such as orthopedic surgery, maxillofacial surgery, plastic surgery, minimal access surgery, and transplant surgery [6][7][8][9][10][11][12][13][14][15][16]. However, a comprehensive analysis of the effect of COVID-19 on hand surgery has not been done.…”

Resumption of the Treatment for Non-COVID-19 Gynecologic Patients after Lifting Lock down: Experiences from Wuhan

“…There are several guidelines published to give recommendations on the safe gynecologic practice and the treatment of gynecologic patients during the ongoing pandemic, focusing onthe management of cancer patients [7][8][9][10][11][12]. Whenthe outbreak peak is gone and the lockdown is lifted, the medical resources should be redirected to none-COVID-19 patients, while the threats of COVID-19 transmission still exist.…”