The Technique and Justification for Minimally Invasive Surgery in COVID-19 Pandemic: Laparoscopic Anterior Resection for Near Obstructed Rectal Carcinoma

Abstract

Introduction:The recent COVID-19 pandemic outbreak has made surgeons change and take on newer strategies and safe exercises. All elective cases have been put off, but oncology cases need to be done to prevent progression of the disease. There is concern about minimally invasive surgery due to aerosol formation. Here we discuss how we have dealt with this in our colorectal surgery department taking into account current evidence about the danger of viral transmission during laparoscopic surgery. Discussion: We report a case of 28 years old female patient with carcinoma rectum. The patient had near total intestinal obstruction. She was operated on utilizing laparoscopic anterior resection. The air seal (CONMED, Utica, NY) and high-efficiency particulate air (HEPA) filter was utilized for safe gas evacuation. There is no evidence against laparoscopic surgery, which suggest viral transmission. One should take utmost precautions using N95 masks and personal protective equipment (PPE). Air filtration products like aerosol, HEPA filters will be of great aid in safe evacuation of gases. Conclusion: At present, there is no solid evidence to suggest viral transmission through surgical smoke. We believe due to effective smoke containment, less blood loss, and less postoperative stay, laparoscopy will be a non-inferior option than open surgical procedure. We advise taking all precautions for operating room staff to lessen the danger of transmission.

Personal protective equipment for surgeons during COVID-19 pandemic: systematic review of availability, usage and rationing

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Laparoscopic Surgery and the debate on its safety during COVID-19 pandemic: A systematic review of recommendations

“… Pawar, Pokharkar, Gori et al. (2020) 25 Journal of Laparo-endoscopic & Advanced Surgical Techniques Case presenta-tion Is there evidence for viral transmission through surgical smoke in laparoscopy? .…”

Use of Tracheostomy During the COVID-19 Pandemic

“…In the absence of NP rooms, Chee et al 35 described the use of single rooms, with locked and sealed doors (with tape) as an alternative (strict door policy). The use of small HEPA filters attached to the airway tubing/ventilator circuit 60 and large HEPA filters for the room have been described in case reports to minimize aerosol dissemination. Reports from the COVID-19 pandemic suggest that PDT has been successfully performed at the bedside in the ICU in New York City, without any documented COVID-19 transmission to HCWs.…”