Saturday 4 July 2020

How elective surgery is safe with due precautions during Covid-19?

Elective Surgery or Procedure is any surgery not involving medical emergency and has been scheduled in advance.


The current Covid-19 health crisis has drastically changed the way that medical and surgical services are provided around the world. To prevent hospitals from being overwhelmed, the healthcare authorities had restricted medical care to emergency cases and postponed elective surgeries. 

While the situation has not normalised to any degree, authorities have started discussing plans to reduce restrictions and restart daily operations, elective surgery being one. This is not something to be taken lightly and the plans can vary from place to place and time to time.

Following are some of the “recommendations”.
  1. Isolating specific facilities for treating Covid-19 reducing the risk of viral transmission. This includes medical personnel and patients. 
  2. Testing, testing, testing. BOTH THE PATIENTS AND MEDICAL PROFESSIONALS MUST BE TESTED. Currently there are 2 tests being done. Polymerase Chain Reaction (PCR) test; a positive indicating current infection. However, as the incubation period is variable, a negative result may be a false negative, so it would be advisable to take an antigen test as close to the procedure as possible. The other is a Serology Test for SARS-CoV-2 antibodies; a positive result showing past infection. It is still unknown if presence of antibodies provides immunity and/or prevents retransmission. 
  3. Bariatric surgery, i.e. surgery performed on obese or overweight people, can also be started, provided all the precautionary measures are taken. This is recommended because of the possible criticality of the cases, and the possibly compromised immune systems.
  4. Non-bariatric surgery, like that for appendicitis, gallstones, hernias and hemorrhoids can also be considered, as hospitals are seeing an increase in complications arising due to their postponement. 
  5. Ensure more than adequate supply of Personal Protective Equipment, like N95 masks, protective face shields and goggles, disposable gloves and gowns, etc.,  for all medical personnel.
  6. All surgeries should be classified as per degree of urgency and indication. Priority being given to essential surgeries.
  7. Keeping the hospital environment clean and safe. This may seem obvious, but is something to be done consciously. It has to be assumed everybody is infected and act accordingly.

It must be noted that even if all the above “recommendations”, and others if any, are satisfied, it is still upto to the medical professional to decide whether to go ahead with the surgery.

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Blog reviewed by: Dr.Nikhil Agnihotri
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