Author(s): Philippine Association of Laparoscopic and Endoscopic Surgeons
In the context of COVID-19, community transmission poses a threat against safety of everyone especially doctors in the frontline.
A lot of discussions have been generated in the past week. As surgeons of PALES, it is our responsibility to inform, educate and raise the level of awareness to prevent, control and eliminate transmission of infection during this crisis especially in COVID-19 hot zones.
Solid data on spread of coronavirus during aerosol generating procedures are still unfounded. However, in laparoscopy, generation of artificial pneumoperitoneum and surgical smoke produced by the use of energy devices become risks for aerosol exposure particularly when there are leaks in trocar sites and during evacuation of pneumoperitoneum. Therefore, for patients who are COVID-19 positive, suspect or asymptomatic, the most important aspect to consider at this point in time is for each surgeon to wear standard surgical personal protective equipment (PPE) which includes a face shield / goggles, N95 mask/ PAPR if available, double gloves, water proof surgical gown and booties and mitigate all aspects of risks from exposure while taking care of patients especially during surgery.
We have gathered resources, available and reviewed various recommendations pertaining to and involving the use of artificial pneumoperitoneum in laparoscopy during COVID-19 and the effects of microparticles generated from surgical smoke. We hope that this set of recommendations for our local setting will help you prepare your team well during this crisis and beyond.
Key words: Laparoscopic Surgery in COVID-19 Pandemic