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Kowalczyk D, Piątkowski S, Porażko M, Woskowska A, Szewczyk K, Brudniak K, Wójtowicz M, Kowalczyk K. Safety of Three-Dimensional versus Two-Dimensional Laparoscopic Hysterectomy during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14163. [PMID: 36361054 PMCID: PMC9654606 DOI: 10.3390/ijerph192114163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/20/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The COVID-19 pandemic has resulted in a significant decrease in the number of surgical procedures performed. Therefore, it is important to use surgical methods that carry the lowest possible risk of virus transmission between the patient and the operating theater staff. AIM Safety evaluation of three-dimensional (3D) versus two-dimensional (2D) laparoscopic hysterectomy during the COVID-19 pandemic. METHODS 44 patients were assigned to a prospective case-control study. They were divided either to 3D (n = 22) or 2D laparoscopic hysterectomy (n = 22). Fourteen laparoscopic supracervical hysterectomies (LASH) and eight total laparoscopic hysterectomies (TLH) were performed in every group. The demographic data, operating time, change in patients' hemoglobin level and other surgical outcomes were evaluated. RESULTS 3D laparoscopy was associated with a significantly shorter operating time than 2D. (3D vs. 2D LASH 70 ± 23 min vs. 90 ± 20 min, p = 0.0086; 3D vs. 2D TLH 72 ± 9 min vs. 85 ± 9 min, p = 0.0089). The 3D and 2D groups were not significantly different in terms of change in serum hemoglobin level and other surgical outcomes. CONCLUSIONS Due to a shorter operating time, 3D laparoscopic hysterectomy seems to be a safer method both for both the surgeon and the patient. Regarding terms of possible virus transmission, it may be particularly considered the first-choice method during the COVID-19 pandemic.
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Affiliation(s)
- Dariusz Kowalczyk
- Department of Anatomy, School of Medicine in Opole, University of Opole, 45-052 Opole, Poland
| | - Szymon Piątkowski
- Students’ Scientific Association of Gynecology and Obstetrics, School of Medicine in Opole, University of Opole, 45-052 Opole, Poland
| | - Maja Porażko
- Students’ Scientific Association of Gynecology and Obstetrics, School of Medicine in Opole, University of Opole, 45-052 Opole, Poland
| | - Aleksandra Woskowska
- Students’ Scientific Association of Gynecology and Obstetrics, School of Medicine in Opole, University of Opole, 45-052 Opole, Poland
| | - Klaudia Szewczyk
- Students’ Scientific Association of Gynecology and Obstetrics, School of Medicine in Opole, University of Opole, 45-052 Opole, Poland
| | - Katarzyna Brudniak
- Students’ Scientific Association of Gynecology and Obstetrics, School of Medicine in Opole, University of Opole, 45-052 Opole, Poland
| | - Mariusz Wójtowicz
- Department of Gynecological and Obstetrics Women’s and Child Health Center, Medical University of Silesia, 41-803 Zabrze, Poland
| | - Karolina Kowalczyk
- Department of Endocrinological Gynecology, Faculty of Medicine in Katowice, Medical University of Silesia, 40-752 Katowice, Poland
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de Souza Maciel Ferreira JE, Rocha de Oliveira L, Galvão Pereira K, Marques Frota N, Frota Cavalcante T, Santos Monte A, Lopes Chaves AF. Estratégias organizacionais no centro cirúrgico diante da pandemia de COVID 19: uma revisão integrativa. REVISTA CUIDARTE 2022. [DOI: 10.15649/cuidarte.2323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Introdução: os sistemas de saúde foram desafiados a desenvolver estratégias organizacionais para a prestação de cuidados cirúrgicos. Objetivo: apresentar as estratégias dos serviços de saúde no que se refere às práticas de cuidados cirúrgicos em tempos de pandemia de COVID-19. Materiais e métodos: revisão integrativa, desenvolvida em seis etapas, cuja busca dos artigos ocorreu na Biblioteca Virtual de Saúde, SciELO, PubMed e ScienceDirect. Os descritores controlados em saúde adotados foram “Centros Cirúrgicos” e “Infecções por Coronavírus”, de acordo com os sistemas DeCS e MeSH Terms. Foram selecionados 60 artigos de 405 estudos encontrados. Resultados: as principais estratégias utilizadas pelos serviços de saúde foram: a suspensão e adiamento de cirurgias eletivas durante as ondas de contágio da doença; e a triagem cuidadosa dos pacientes para COVID-19 antes e após intervenções cirúrgicas. Discussão: a suspensão e o adiamento de cirurgias eletivas devem ser avaliados com cautela pela equipe de saúde, de forma individualizada, para cada paciente, visto que situações clínicas não urgentes podem agravar ao longo do tempo, aumentando as chances de morbimortalidade desses pacientes. Conclusão: a triagem dos pacientes e dos profissionais da saúde para COVID-19 são estratégias importantes para evitar a contaminação desses sujeitos. A suspensão e o adiamento de cirurgias eletivas, durante as ondas de contágio por COVID-19, são recomendados para aumentar a capacidade de leitos disponíveis para pacientes graves hospitalizados por essa doença. Essa recomendação também auxilia no remanejamento de profissionais desse setor para as unidades com a demanda de cuidados de saúde mais elevada.
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Chia DKA, Lim Z, Ang JJ, Tambyah PA, Lau KSH, Ong J, Chow VTK, Allen DM, Fung J, Lau KJX, Luhung I, Schuster SC, Lee CN, Kim G, So JBY, Lomanto D, Shabbir A. Coronavirus viability in surgical plume and methods for safe disposal: a preclinical model. Br J Surg 2021; 109:15-20. [PMID: 34792098 DOI: 10.1093/bjs/znab385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 09/23/2021] [Indexed: 11/14/2022]
Abstract
Smoke generated by cautery devices used during surgery may contain infective particles and may cause transmission of airborne viruses. This study determines whether live viruses are present in surgical smoke and evaluates the effectiveness of several proposed methods of removal so as to improve safety of healthcare workers.
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Affiliation(s)
- Daryl K A Chia
- Department of Surgery, University Surgical Cluster, National University Health System, Singapore
| | - Zhixue Lim
- Department of Hand & Reconstructive Microsurgery, University Orthopaedic, Hand & Reconstructive Microsurgical Cluster, National University Health System, Singapore
| | - Jia Jun Ang
- Department of Surgery, University Surgical Cluster, National University Health System, Singapore
| | - Paul A Tambyah
- Division of Infectious Diseases, Department of Medicine, University Medical Cluster, National University Health System, Singapore
| | - Kelly S H Lau
- Infectious Diseases Translational Research Programme, Department of Microbiology & Immunology, Yong Loo Lin School of Medicine, National University of Singapore
| | - Joe Ong
- Infectious Diseases Translational Research Programme, Department of Microbiology & Immunology, Yong Loo Lin School of Medicine, National University of Singapore
| | - Vincent T K Chow
- Infectious Diseases Translational Research Programme, Department of Microbiology & Immunology, Yong Loo Lin School of Medicine, National University of Singapore
| | - David M Allen
- Division of Infectious Diseases, Department of Medicine, University Medical Cluster, National University Health System, Singapore
| | - Javis Fung
- Division of General Surgery (Upper Gastrointestinal Surgery), Department of Surgery, University Surgical Cluster, National University Health System, Singapore
| | - Kenny J X Lau
- Singapore Centre for Environmental Life Sciences Engineering, Nanyang Technological University, Singapore
| | - Irvan Luhung
- Singapore Centre for Environmental Life Sciences Engineering, Nanyang Technological University, Singapore
| | - Stephan C Schuster
- Singapore Centre for Environmental Life Sciences Engineering, Nanyang Technological University, Singapore
| | - Chuen Neng Lee
- Department of Surgery, University Surgical Cluster, National University Health System, Singapore
| | - Guowei Kim
- Department of Surgery, University Surgical Cluster, National University Health System, Singapore.,Division of General Surgery (Upper Gastrointestinal Surgery), Department of Surgery, University Surgical Cluster, National University Health System, Singapore
| | - Jimmy B Y So
- Department of Surgery, University Surgical Cluster, National University Health System, Singapore.,Division of General Surgery (Upper Gastrointestinal Surgery), Department of Surgery, University Surgical Cluster, National University Health System, Singapore.,Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Davide Lomanto
- Department of Surgery, University Surgical Cluster, National University Health System, Singapore.,Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Minimally Invasive Surgical Centre, Department of Surgery, National University Health System, Singapore
| | - Asim Shabbir
- Department of Surgery, University Surgical Cluster, National University Health System, Singapore.,Division of General Surgery (Upper Gastrointestinal Surgery), Department of Surgery, University Surgical Cluster, National University Health System, Singapore.,Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Kurihara H. Emergency surgery and trauma during COVID-19 pandemic: safe, smart and kind! Eur J Trauma Emerg Surg 2021; 47:619-620. [PMID: 34100964 PMCID: PMC8186015 DOI: 10.1007/s00068-021-01682-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Hayato Kurihara
- Emergency Surgery and Trauma Unit, IRCCS, Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Italy.
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Ferko N, Wright GWJ, Syed I, Naoumtchik E, Tommaselli GA, Gangoli G. A device category economic model of electrosurgery technologies across procedure types: a U.S. hospital budget impact analysis. J Med Econ 2021; 24:524-535. [PMID: 33851557 DOI: 10.1080/13696998.2021.1915626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIMS The electrosurgical technology category is used widely, with a diverse spectrum of devices designed for different surgical needs. Historically, hospitals are supplied with electrosurgical devices from several manufacturers, and those devices are often evaluated separately; it may be more efficient to evaluate the category holistically. This study assessed the health economic impact of adopting an electrosurgical device-category from a single manufacturer. METHODS A budget impact model was developed from a U.S. hospital perspective. The uptake of electrosurgical devices from EES (Ethicon Electrosurgery), including ultrasonic, advanced bipolar, smoke evacuators, and reusable dispersive electrodes were compared with similar MED (Medical Energy Devices) from multiple manufacturers. It was assumed that an average hospital performed 10,000 annual procedures 80% of which involved electrosurgery. Current utilization assumed 100% MED use, including advanced energy, conventional smoke mitigation options (e.g. ventilation, masks), and single-use disposable dispersive electrode devices. Future utilization assumed 100% EES use, including advanced energy devices, smoke evacuators (i.e. 80% uptake), and reusable dispersive electrodes. Surgical specialties included colorectal, bariatric, gynecology, thoracic and general surgery. Systematic reviews, network meta-analyses, and meta-regressions informed operating room (OR) time, hospital stay, and transfusion model inputs. Costs were assigned to model parameters, and price parity was assumed for advanced energy devices. The costs of disposables for dispersive electrodes and smoke-evacuators were included. RESULTS The base-case analysis, which assessed the adoption of EES instead of MED for an average U.S. hospital predicted an annual savings of $824,760 ($101 per procedure). Savings were attributable to associated reductions with EES in OR time, days of hospital stay, and volume of disposable electrodes. Sensitivity analyses were consistent with these base-case findings. CONCLUSIONS Category-wide adoption of electrosurgical devices from a single manufacturer demonstrated economic advantages compared with disaggregated product uptake. Future research should focus on informing comparisons of innovative electrosurgical devices.
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Affiliation(s)
| | | | | | - Elena Naoumtchik
- Johnson & Johnson Medical Devices Companies, Cincinnati, OH, USA
| | | | - Gaurav Gangoli
- Johnson & Johnson Medical Devices Companies, Cincinnati, OH, USA
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Serban D, Smarandache CG, Tudor C, Duta LN, Dascalu AM, Aliuș C. Laparoscopic Surgery in COVID-19 Era-Safety and Ethical Issues. Diagnostics (Basel) 2020; 10:E673. [PMID: 32899885 PMCID: PMC7555582 DOI: 10.3390/diagnostics10090673] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/26/2020] [Accepted: 09/02/2020] [Indexed: 12/11/2022] Open
Abstract
(1) Background: The paper aims to review the available evidence regarding the health risk of the aerosolization induced by laparoscopy induced and impact of the COVID-19 pandemic upon minimally invasive surgery. (2) Materials and methods: A systematic review of the literature was performed on PubMed, Medline and Scopus until 10 July. (3) Results: Chemicals, carcinogens and biologically active materials, such as bacteria and viruses, have been isolated in surgical smoke. However, the only evidence of viral transmission through surgical smoke to medical staff is post-laser ablation of HPV-positive genital warts. The reports of SARS-CoV-2 infected patients who underwent laparoscopic surgery revealed the presence of the virus, when tested, in digestive wall and stools in 50% of cases but not in bile or peritoneal fluid. All surgeries did not result in contamination of the personnel, when protective measures were applied, including personal protective equipment (PPE) and filtration of the pneumoperitoneum. There are no comparative studies between classical and laparoscopic surgery. (4) Conclusions: Previously published data showed there is a possible infectious and toxic risk related to surgical smoke but not particularly proven for SARS-CoV-2. Implementing standardized filtration systems for smoke evacuation during laparoscopy, although increases costs, is necessary to increase the safety and it will probably remain a routine also in the future.
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Affiliation(s)
- Dragos Serban
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy Bucharest, 030167 Bucharest, Romania; (C.G.S.); (A.M.D.)
- IVth Department of Surgery, Emergency University Hospital Bucharest, 050098 Bucharest, Romania; (C.T.); (L.N.D.); (C.A.)
| | - Catalin Gabriel Smarandache
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy Bucharest, 030167 Bucharest, Romania; (C.G.S.); (A.M.D.)
- IVth Department of Surgery, Emergency University Hospital Bucharest, 050098 Bucharest, Romania; (C.T.); (L.N.D.); (C.A.)
| | - Corneliu Tudor
- IVth Department of Surgery, Emergency University Hospital Bucharest, 050098 Bucharest, Romania; (C.T.); (L.N.D.); (C.A.)
| | - Lucian Nicolae Duta
- IVth Department of Surgery, Emergency University Hospital Bucharest, 050098 Bucharest, Romania; (C.T.); (L.N.D.); (C.A.)
| | - Ana Maria Dascalu
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy Bucharest, 030167 Bucharest, Romania; (C.G.S.); (A.M.D.)
| | - Cătălin Aliuș
- IVth Department of Surgery, Emergency University Hospital Bucharest, 050098 Bucharest, Romania; (C.T.); (L.N.D.); (C.A.)
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