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How to manage smoke evacuation & filter pneumoperitoneum during laparoscopy to minimize viral spread скачать в хорошем качестве

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How to manage smoke evacuation & filter pneumoperitoneum during laparoscopy to minimize viral spread

How to manage smoke evacuation and filter pneumoperitoneum during laparoscopy to minimize potential viral spread: different methods from SoMe - a video vignette MIS filtration group* Even if previous studies on HBV showed that hepatitis virus could be found in the intrabdominal gas, there are no evidences of SARS-CoV2 particles in the gas used during laparoscopy so far, but it is prudent to perform laparoscopy with safety strategies aiming to avoid diffusion of potentially infected intrabdominal aerosol in the operating room. Appropriate personal protective equipment (PPE) based on patient status and adequate precautions must be adopted, using ultrafiltration (smoking evacuators and/or filters) during the procedure and monitoring of smoke/gas evacuation and final exsufflation. Trocar incisions should be minimized to avoid gas leakage around ports, with CO2 insufflation and pneumoperitoneum at minimum possible level. Ports should be maintained closed during the procedure, evacuating all pneumoperitoneum via the filtering system before extracting the specimens and removing trocars. Commercially available closed filtration systems are recommended by the Canadian Association of General Surgeons, that discourage the use of non-filtered devices. During the last weeks, surgeons have shared on social media various methods to filter gas in laparoscopy during COVID-19 pandemic, where other systems are not available. In this vignette, the authors present some strategies proposed. The readers are made aware that, due to the rapidly evolving scenario, it is recommended to check regularly for updates about the correct measures to adopt when performing laparoscopy during the COVID-19 pandemic. Hopefully, this trend towards a higher-level of safety in surgery may result in a definitive adoption of the strategies described in the video. *Authors List: Conception and design, collection of material, drafting of the text, preparation of the video: Francesco Pata (corresponding author, General Surgery Unit, Nicola Giannettasio Hospital, Corigliano-Rossano, Italy and La Sapienza University, Rome, Italy), Alvaro García-Granero (Colorectal Unit, Son Espases University Hospital, Palma de Mallorca, Spain), Gianluca Pellino (Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy and Vall d’Hebron University Hospital, Barcelona, Spain) Co-authors (order based on date technique shared on SoMe): Isabel Pascual-Miguelañez, Mario Alvarez- Gallego (Colorectal Surgery Department, Hospital Universitario La Paz, Madrid, Spain); Manuel Losada Ruiz, Miguel Hernández García, Beatriz Diéguez Fernández, Alberto Vaquero Rodriguez, Alfredo Alonso Poza (Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Arganda del Rey, Madrid, Spain); Carlos Yánez Benítez, Beatriz Cros Montalban, Ana Nogués Pedival, Juan L Blas Laina (General and GI Surgical Department, Hospital Royo Villanova, Zaragoza, Spain); Mariana García Virosta, Daniel Sánchez López (Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid); Vincenzo Vigorita, Alberto San Ildefonso Pereira, Enrique Moncada Iribarren, Raquel Sanchez Santos (Department of General and Digestive Surgery - University Hospital Complex of Vigo - Galicia Sur Health Research Institute, IIS Galicia Sur, Spain); Julià Diez Izquierdo, Felipe García Sanchez, Esther Cano Pecharroman, Teresa Calderon Duque (Hospital Nuestra Sra Del Prado, Talavera de la Reina, Toledo, Spain); Jorge Alejandro Benavides Buleje, Nuria Martinez Sanz, Pedro López Morales, Emilio Peña Ros, Pedro Antonio Parra Baños (Hospital General Universitario Reina Sofía, Murcia, Spain); Antonino Spinelli, Francesco Carrano (Division of Colon and Rectal Surgery, Humanitas Clinical and Research Hospital, Milano, Italy); Daniel Costa Henere, Eric Herrero Fonollosa (Hospital Universitario Mútua Terrassa, Spain); Francesc Xavier Molina-Romero, Natalia Pujol Cano, Elías Palma-Zamora, Jose Miguel Morón Canis, Francesc Xavier González-Argente (Son Espases University Hospital, Palma de Mallorca, Spain)

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