Maintaining a minimally invasive surgical service during a pandemic

Area of Science:

• Surgical Innovation
• Infectious Disease Epidemiology
• Patient Safety

Background:

• The COVID-19 pandemic raised concerns about disease transmission during surgical procedures.
• Minimally invasive surgery (MIS) was questioned due to potential aerosol generation and disease spread.
• Open surgery (OS) was considered a potentially safer alternative in the early pandemic.

Purpose of the Study:

• To evaluate the safety of performing minimally invasive surgery (MIS) during the COVID-19 pandemic.
• To compare complication rates, respiratory issues, length of stay, and surgeon infections between MIS and open surgery (OS).
• To determine if MIS can be safely conducted with appropriate protective measures in a high-prevalence COVID-19 environment.

Main Methods:

• A comparative study analyzing surgical operations performed during the 2020 COVID-19 lockdown.
• Comparison groups included operations from the same periods in 2019 and 2021 to establish baseline data.
• Key outcomes assessed were overall complications, respiratory complications, length of stay (LOS), and operating surgeon COVID-19 infections (OSI).

Main Results:

• In 2020, 52% of procedures were MIS. Complication rates were 29% for MIS versus 47% for OS (p=0.04).
• Respiratory complication rates were similar between MIS (8.5%) and OS (10.5%) in 2020.
• Median length of stay was shorter for MIS (2.5 days) compared to OS (5 days) in 2020; no operating surgeon COVID-19 infections were reported.

Conclusions:

• Minimally invasive surgery (MIS) can be performed safely during the COVID-19 pandemic.
• Appropriate protective measures mitigate the risks associated with MIS in a high-prevalence COVID-19 setting.
• No increase in patient or operating surgeon complications was observed with MIS during the pandemic.