Surgical Implications of COVID-19

Abstract

At present, the world is in the midst of a COVID-19 pandemic. However, the incidence of surgically treated disorders remains the same. In many countries resources, which were otherwise available to surgical patients, have been allocated to COVID-19 patients. Therefore, surgical resources need to be prioritized for the most-needy surgical patients. Surgical and obstetric emergencies need to be attended to without delay. Urgent operations also need to be performed to save life or limb. Semi-elective operations including oncological surgeries need to be performed within 4 weeks, whilst many elective surgeries can be safely delayed. Regional anaesthesia is preferable to general anaesthesia during the epidemic as it carries a lower risk of disease transmission. Strict infection control measures should be adopted in the operating theatre. Although there were initial concerns about the safety of minimal access surgery, recent evidence indicates that it is safe during this epidemic. Lung transplantation has been preformed successfully in a few patients with severe COVID-19 pneumonia but there is insufficient evidence to justify its more widespread use. Most pregnant COVID-19 women who delivered, did so successfully by caesarian section under spinal anaesthesia. Surgical care during this epidemic has to be customized to suit the individual setting.