ESGE Recommendations on Gynaecological Laparoscopic Surgery during COVID-19 outbreak
Global coronavirus pandemic has become the dominant issue throughout the world whilst the governments, nations and health services are trying to deal with its impact. Many countries are in either complete or partial lockdown to reduce the speed of transmission and save lives. Meanwhile healthcare systems are diverting their resources to looking after patients infected by the coronavirus. At the same time, women continue to present with gynaecological emergencies or are diagnosed with cancer treatment of which cannot be postponed. In order to guide our members and other colleagues organise their priorities and minimise the risk to themselves and their patients, the ESGE Executive Board has decided to release this statement.
- During the time of crisis the healthcare providers need to be able to concentrate their resources on the care of people severely affected by the coronavirus, hence elective operations for benign conditions should not be carried out during the pandemic. When possible, alternative medical treatment approaches should be considered to minimise suffering and keep women at home, away from hospitals.
- Depending on the availability and priorities of the healthcare system, it would be useful to screen patients for corona virus infection before planned surgical treatment, when possible.
- In suspected or documented Covid-19 positive patients, surgery should be postponed until full recovery, if there is no immediate life threatening situation. Consideration should be given to non-surgical alternatives when possible. If this is not possible, surgery must be performed with full Personal Protective Equipment (PPE) worn by the entire theatre staff to reduce the risk of transmission.
- Hospitals should have arrangements in place to be able to look after women with gynaecological emergencies. Hospitals should also be able to care for women with possible gynaecological cancer and treat those who have been diagnosed with gynaecological cancer. Surgery for gynaecological cancer should continue, unless alternative interim options are possible until the end of the outbreak.
- Laparoscopic surgery for gynaecological emergencies and cancer would be beneficial for the health system by reducing hospital stay, compared to open surgery. However, this should be weighed against possible disadvantages of laparoscopic surgery during the outbreak