Detect to protect: pneumoperitoneum gas samples for SARS-CoV-2 and biohazard testing

Excerpt

As we walk through a period of uncertainty, it becomes essential to obtain clear, prompt, and evidence-based indications to guide surgeons and protect OR staff. The SARS-CoV-2 pandemic profoundly modified the patients’ case load of most surgical units, affecting both the volume and the quality of care: different behaviors have been suggested to regulate surgical and endoscopic activity during the emergency [1‐6] and a significant concern has been raised about the possibility of contagion from patients affected by COVID-19 infection during interventional procedures. It is known that surgical smoke and aerosol generated during a surgical procedure can contain viruses, which in some circumstances has led to infection [7‐9]; however, no data have demonstrated the presence of SARS-CoV-2 in the smoke generated during a surgical procedure yet. Moreover, SARS-CoV-2 non-respiratory transmission is still under investigation. Fecal-oral transmission has also been suggested, while viral clearance modality and its timing are not entirely understood [10‐15]. Additional concerns were raised about the risk of infection associated with the use of laparoscopy. It has therefore been suggested to reduce the working pressure during abdominal laparoscopy to a minimum and some have also questioned if laparoscopy should be used at all during the pandemics. National guidelines have indeed advised to consider alternative treatments, whenever possible, underlying the suspect of an increased risk of contamination for laparoscopic procedures due to the aerosol diffusion in the OR environment. …