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
Giorgio Bogani27
Estimated H-index: 27
,
Antonino Ditto28
Estimated H-index: 28
+ 6 AuthorsFrancesco Raspagliesi43
Estimated H-index: 43
Sources
Abstract
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.
References12
Newest
#1Meriem LaamartiH-Index: 4
#2Tarek AlouaneH-Index: 5
Last. Azeddine IbrahimiH-Index: 22
view all 22 authors...
In late December 2019, an emerging viral infection COVID-19 was identified in Wuhan, China, and became a global pandemic. Characterization of the genetic variants of SARS-CoV-2 is crucial in following and evaluating it spread across countries. In this study, we collected and analyzed 3,067 SARS-CoV-2 genomes isolated from 55 countries during the first three months after the onset of this virus. Using comparative genomics analysis, we traced the profiles of the whole-genome mutations and compared...
27 CitationsSource
#1Federico CoccoliniH-Index: 46
#1Federico Coccolini (U of C: University of Calgary)H-Index: 1
Last. Massimo ChiarugiH-Index: 22
view all 7 authors...
Background: The excretion pathomechanisms of SARS-CoV-2 are actually unknown No certain data exist about viral load in the different body compartments and fluids during the different disease phases Material and Methods: Specific real-time reverse transcriptase-polymerase chain reaction targeting 3 SARS-CoV-e genes were used to detect the presence of the virus
54 CitationsSource
#1Alice Indini (Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico)H-Index: 10
#2Erika Rijavec (Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico)H-Index: 16
Last. Francesco Grossi (Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico)H-Index: 34
view all 8 authors...
Abstract The novel coronavirus respiratory illness (COVID-19) is a public health emergency of global concern. Patients with cancer are at high risk of infections, due to an overall immunocompromised status. However, this connection is not straightforward for coronavirus (CoV) infection, in which the host immune response is the main driver of tissue damage. We performed a thorough review of data on CoV pathogenesis and morbidity rate in cancer patients, through the analysis of the previous CoV pa...
6 CitationsSource
#1Giorgio BoganiH-Index: 27
#2Antonino DittoH-Index: 28
Last. Francesco RaspagliesiH-Index: 43
view all 5 authors...
Objective SARS-CoV-2 pandemic is continuing to spread There are growing concerns on the impact of COVID-19 in cancer patients Several papers reporting recommendations and guidelines are published But few data on cancer patients affected by COVID-19 are available Methods This is a retrospective study including all consecutive patients affected by gynecological cancer who developed COVID-19 All patients were treated in an academic setting (in Milan, Lombardy, Italy) between February and March 2020...
12 CitationsSource
#1Sven FlemmingH-Index: 8
#2Mohammed K. HankirH-Index: 15
Last. Armin WiegeringH-Index: 15
view all 8 authors...
8 CitationsSource
The World Health Organization (WHO) classified the novel coronavirus (i.e., coronavirus disease 2019 [COVID-19]) as a global public health emergency. COVID-19 threatens to curtail patient access to evidence-based treatment. Medicine is changing, basically due to the limited available resources. In the field of gynecologic oncology, we have to re-design our treatments' paradigm. During COVID-19 pandemic outbreak, the highest priority is to achieve the maximum benefit from less demanding procedure...
8 CitationsSource
#1Hassan Raza (University of Management and Technology)H-Index: 1
#2Braira Wahid (University of Management and Technology)H-Index: 7
Last. Adil GulzarH-Index: 1
view all 4 authors...
Abstract Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or COVID-2019 is a new global health challenge which causes severe respiratory complications. As of May 17th, 2020, SARS-CoV-2 has infected 4.6 million people and caused 310,000 deaths, worldwide. In order to study potential impact of infection, complete epidemiological information should be reported on regular basis however, data from Pakistan has not yet been published. This retrospective study is the first report of epidemi...
5 CitationsSource
#1Franco Valenza (University of Milan)H-Index: 28
#2Gabriele PapagniH-Index: 1
Last. Giovanni ApoloneH-Index: 54
view all 17 authors...
Background:The rapid spread of coronavirus disease (COVID-19) is affecting many countries. While healthcare systems need to cope with the need to treat a large number of people with different degre...
15 CitationsSource
14 CitationsSource
#1Giorgio BoganiH-Index: 27
#2Jvan Casarin (University of Insubria)H-Index: 17
Last. Francesco RaspagliesiH-Index: 43
view all 12 authors...
At the beginning of 2020,�coronavirus disease 2019 (COVID-19) spreads worldwide. Patients with ovarian cancer should be considered at high-risk of developing severe morbidity related to COVID-19. Most of them are diagnosed in advanced stages of disease, and they are fragile. Here, we evaluated the major impact of COVID-19 on patients with ovarian cancer, discussing the effect of the outbreak on medical and surgical treatment.
8 CitationsSource
Cited By0
Newest