Electrocautery, diathermy, and surgical energy devices: are surgical teams at risk during the COVID-19 pandemic?
File(s)ANNSURG-D-20-01577 Proofs.pdf (223.27 KB)
Accepted version
Author(s)
Type
Journal Article
Abstract
OBJECTIVE: The aim of the study was to provide a rapid synthesis of available data to identify the risk posed by utilizing surgical energy devices intraoperatively due to the generation of surgical smoke, an aerosol. Secondarily it aims to summarize methods to minimize potential risk to operating room staff. SUMMARY BACKGROUND DATA: Continuing operative practice during the coronavirus disease-19 (COVID-19) pandemic places the health of operating theatre staff at potential risk. SARS-CoV2 is transmitted through inhaled droplets and aerosol particles, thus posing an inhalation threat even at considerable distance. Surgical energy devices generate an aerosol of biological particular matter during use. The risk to healthcare staff through use of surgical energy devices is unknown. METHODS: This review was conducted utilizing a rapid review methodology to enable efficient generation and dissemination of information useful for concurrent clinical practice. RESULTS: There are conflicting stances on the use of energy devices and laparoscopy by different surgical governing bodies and societies. There is no definitive evidence that aerosol generated by energy devices may carry active SARS-CoV2 virus. However, investigations of other viruses have demonstrated aerosolization through energy devise use. Measures to reduce potential transmission include appropriate personal protective equipment, evacuation and filtration of surgical plume, limiting energy device use if appropriate, and adjusting endoscopic and laparoscopic practice (low CO2 pressures, evacuation through ultrafiltration systems). CONCLUSIONS: The risk of transmission of SARS-CoV2 through aerosolized surgical smoke associated with energy device use is not fully understood, however transmission is biologically plausible. Caution and appropriate measures to reduce risk to healthcare staff should be implemented when considering intraoperative use of energy devices.
Date Issued
2020-09
Date Acceptance
2020-06-01
Citation
Annals of Surgery, 2020, 272 (3), pp.e257-e262
ISSN
0003-4932
Publisher
Lippincott, Williams & Wilkins
Start Page
e257
End Page
e262
Journal / Book Title
Annals of Surgery
Volume
272
Issue
3
Copyright Statement
© 2020 Wolters Kluwer Health, Inc. All rights reserved.
Sponsor
Imperial College Healthcare NHS Trust- BRC Funding
Imperial College Healthcare NHS Trust- BRC Funding
Imperial College Healthcare NHS Trust- BRC Funding
Imperial College Healthcare NHS Trust- BRC Funding
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/32541232
Grant Number
RDB04 79560
RD207
RDB04
RDA27
Subjects
PanSurg collaborative group
Surgery
11 Medical and Health Sciences
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2020-06-09