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对于疑似或感染 COVID-19 的患者，我们如何将腹腔镜手术过程中病毒污染的潜在风险降到最低？

How can we minimize the potential risk of viral contamination during laparoscopic procedures for suspected or infected COVID-19 patients?

机构信息

Department of Gynecology and Obstetrics, Hôpital Femme Mère Enfant, HFME, 59 Boulevard Pinel, Hospices Civils de Lyon, 69000, Lyon, France; Université Claude Bernard Lyon 1, EMR 3738, 69000, Lyon, France.

Department of Anesthesiology, Hôpital Femme Mère Enfant, HFME, 59 Boulevard Pinel, Hospices CIvils de Lyon, 69000, Lyon, France.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2020 Dec;255:63-66. doi: 10.1016/j.ejogrb.2020.10.011. Epub 2020 Oct 16.

DOI:10.1016/j.ejogrb.2020.10.011
PMID:33086141
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7561521/
Abstract

Several societies have raised the risk of viral transmission of SARS-Cov-2 due to surgical smoke during laparoscopic procedures in infected patients. We propose to discuss this issue and to describe specific measures during laparoscopic procedures and a new homemade closed filtration system for smoke evacuation. Since the outbreak of COVID-19, performing a laparoscopy should meet multi-modal requirements. Surgical smoke evacuation device may be an effective tool in reducing exposure to surgical smoke and aerosols.

摘要

由于感染患者在腹腔镜手术中产生的手术烟雾，一些社会机构已经提高了 SARS-CoV-2 病毒传播的风险。我们建议讨论这个问题，并描述在腹腔镜手术期间的具体措施，以及一种新的用于烟雾清除的国产封闭式过滤系统。自 COVID-19 爆发以来，进行腹腔镜检查应满足多种模式的要求。手术烟雾清除装置可能是减少手术烟雾和气溶胶暴露的有效工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edd1/7561521/e296b87b4661/gr2_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edd1/7561521/d031b8ae365c/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edd1/7561521/e296b87b4661/gr2_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edd1/7561521/d031b8ae365c/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edd1/7561521/e296b87b4661/gr2_lrg.jpg

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本文引用的文献

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Underwater-seal evacuation of surgical smoke in laparoscopy during the COVID-19 pandemic: A feasibility report of a simple technique.2019冠状病毒病大流行期间腹腔镜手术烟雾的水下密封式排出：一项简单技术的可行性报告
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SARS-Cov-2 in peritoneal fluid: an important finding in the Covid-19 pandemic.
SARS-CoV-2 在腹腔液中的存在：新冠疫情中的一个重要发现。
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Technics to put on and remove personal protective equipment before surgical or obstetrical procedure in suspected or infected COVID-19 patients (with video).疑似或感染新型冠状病毒肺炎患者在外科手术或产科手术前穿戴和摘除个人防护装备的技术（附视频）
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The risk of COVID-19 transmission by laparoscopic smoke may be lower than for laparotomy: a narrative review.腹腔镜烟雾传播 COVID-19 的风险可能低于剖腹手术：叙述性综述。
Surg Endosc. 2020 Aug;34(8):3298-3305. doi: 10.1007/s00464-020-07652-y. Epub 2020 May 26.
7
Clearing the air: an accessible system for suction and safe evacuation of pneumoperitoneum during laparoscopy in patients with COVID-19.净化空气：一种用于COVID-19患者腹腔镜手术期间气腹吸引和安全排气的便捷系统。
Br J Surg. 2020 Jun;107(7):e200. doi: 10.1002/bjs.11683. Epub 2020 May 7.
8
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Ann R Coll Surg Engl. 2020 May;102(5):392-393. doi: 10.1308/rcsann.2020.0079. Epub 2020 Apr 23.
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