Department of Surgery, University of Chicago Medical Center, 5841 S. Maryland, Rm. G-210, Chicago, IL, 60637, USA.
J Gastrointest Surg. 2020 Jul;24(7):1686-1691. doi: 10.1007/s11605-020-04592-9. Epub 2020 Apr 13.
Among surgeons worldwide, a concern with the use of minimally invasive techniques has been raised due to a proposed risk of viral transmission of the coronavirus disease of 2019 (COVID-19) with the creation of pneumoperitoneum. Due to this proposed concern, we sought to collect the available data and evaluate the use of laparoscopy and the risk of COVID-19 transmission.
A literature review of viral transmission in surgery and of the available literature regarding the transmission of the COVID-19 virus was performed. We additionally reviewed surgical society guidelines and recommendations regarding surgery during this pandemic.
Few studies have been performed on viral transmission during surgery, but to date there is no study that demonstrates or can suggest the ability for a virus to be transmitted during surgical treatment whether open or laparoscopic. There is no societal consensus on limiting or restricting laparoscopic or robotic surgery; however, there is expert consensus on the modification of standard practices to minimize any risk of transmission.
Despite very little evidence to support viral transmission through laparoscopic or open approaches, we recommend making modifications to surgical practice such as the use of smoke evacuation and minimizing energy device use among other measures to minimize operative staff exposure to aerosolized particles.
由于在建立气腹时可能存在冠状病毒病 2019（COVID-19）的病毒传播风险，全世界的外科医生都对微创技术的使用表示担忧。鉴于这种担忧，我们试图收集现有数据并评估腹腔镜的使用情况和 COVID-19 传播的风险。
对手术中的病毒传播以及有关 COVID-19 病毒传播的现有文献进行了文献回顾。我们还审查了有关大流行期间手术的外科协会指南和建议。
尽管很少有研究针对手术期间的病毒传播进行，但迄今为止，没有任何研究能够证明或暗示病毒能够在开放或腹腔镜手术期间传播。尚无关于限制或限制腹腔镜或机器人手术的社会共识；但是，专家们一致认为应修改标准实践以最大程度地降低任何传播风险。
尽管几乎没有证据表明病毒通过腹腔镜或开放性方法传播，但我们建议对手术实践进行修改，例如使用烟雾清除以及在其他措施中尽量减少能量设备的使用，以最大程度地减少手术人员对雾化颗粒的暴露。
