Rishi Singhal, Luke Dickerson, Nasser Sakran, Sjaak Pouwels, Sonja Chiappetta, Sylvia Weiner, Sanjay Purkayastha, Brij Madhok, Kamal Mahawar
Author Information
Rishi Singhal: Upper GI Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham Heartlands Hospital, Birmingham, UK. singhal_rishi@hotmail.com. ORCID
Luke Dickerson: Department of General Surgery, Leighton Hospital, Crewe, UK.
Nasser Sakran: Director Bariatric Centre, Department of Surgery, Emek Medical Centre, Afula, Israel.
Sjaak Pouwels: Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, the Netherlands.
Sonja Chiappetta: Head Obesity and Metabolic Surgery, Ospedale Evangelico Betania, Naples, Italy.
Sylvia Weiner: Department of Obesity and Metabolic Surgery, Krankenhaus Nordwest, Frankfurt am Main, Germany.
Sanjay Purkayastha: Imperial College London, London, UK.
Brij Madhok: Royal Derby Hospital, Derby, UK.
Kamal Mahawar: Bariatric Unit, South Tyneside and Sunderland NHS Trust, Sunderland, UK.
PURPOSE OF REVIEW: Coronavirus Disease-2019 (COVID-19) has had an enormous impact on all aspects of healthcare, but its effect on patients needing surgery and surgeons has been disproportionate. In this review, we aim to understand the impact of the pandemic on surgical patients and teams. We compiled the emerging data on pre-operative screening methods, vaccinations, safe-surgery pathways and surgical techniques and make recommendations for evidence-based safe-surgical pathways. We also present surgical outcomes for emergency, oncological and benign surgery in the context of the pandemic. Finally, we attempt to address the impact of the pandemic on patients, staff and surgical training and provide perspectives for the future. RECENT FINDINGS: Surgical teams have developed consensus guidelines and established research priorities and safety precautions for surgery during the COVID-19 pandemic. Evidence supports that surgery in patients with a peri-operative SARS-CoV-2 infection carries substantial risks, but risk mitigation strategies are effective at reducing harm to staff and patients. Surgery has increased risk for patients and staff, but this can be mitigated effectively, especially for elective surgery. Elective surgery can be safely performed during the COVID-19 pandemic employing the strategies discussed in this review.
