Transmission of SARS-CoV-2 in Surgical Smoke during Laparoscopy: A Prospective, Proof-of-concept Study.
Published on Dec 26, 2020in Journal of Minimally Invasive Gynecology3.107
· DOI :10.1016/J.JMIG.2020.12.026
Abstract Study Objective There are growing concerns on the potential risk of COVID-19 transmission during surgery and in particular during minimally invasive procedure, due to the aerosolization of SARS-CoV-2 particles. However, no study demonstrated this hypothesis. Here, we aimed to investigate the presence SARS-CoV-2 through surgical smoke. Design A prospective pilot study. Setting A third-level cancer center in Northern Italy. Patients Overall, 17 patients had laparoscopic approach for the management for suspected or documented gynecological malignancies. Median age was 57 (range, 26-77) years. Surgical indication included: endometrial cancer (n=11), borderline ovarian tumor (n=3), early-stage ovarian cancer (n=1), stage IA cervical cancer, following diagnostic conization (n=1), and an ovarian cyst, resulted benign at final histological examination (n=1). Interventions We evaluated all consecutive women scheduled to have laparoscopic procedures for suspected / documented gynecological cancers. Patients had planned laparoscopic surgery. At the end of laparoscopic procedures (after extubation), we performed RT-PCR for detection of SARS-CoV-2 from both the endotracheal tube and the filter applied on the trocar valve Measurements and Main Results In one patient both swabs (endotracheal tube and trocar's filter) showed amplification of the N gene at RT-PCR analysis. This case was considered as presumptive positive case. In another case, RT-PCR showed an amplification curve for the N gene only in the swab performed on the filter. No ORF1ab amplification was detected. Conclusion Our study suggested the proof of principle that SARS-CoV-2 might be transmitted through the surgical smoke and aerosolized native fluid from the abdominal cavity.