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Case Reports
. 2020 Dec;30(6):e43-e45.
doi: 10.1097/SLE.0000000000000837.

SARS-Cov-2 Was Not Found in the Peritoneal Fluid of an Asymptomatic Patient Undergoing Laparoscopic Appendectomy

Gustavo Romero-Velez  1 , Xavier Pereira, Ariela Zenilman, Diego Camacho
Affiliations
Case Reports

SARS-Cov-2 Was Not Found in the Peritoneal Fluid of an Asymptomatic Patient Undergoing Laparoscopic Appendectomy

Gustavo Romero-Velez et al. Surg Laparosc Endosc Percutan Tech. 2020 Dec.

Abstract

Background: The safety of laparoscopic surgery in SARS-CoV-2 positive patients remains unclear. The presence of the virus within peritoneal fluid and the peritoneal tissues is not known. We report an asymptomatic COVID-19 positive patient who underwent laparoscopic appendectomy with negative peritoneal sampling for SARS-CoV-2.

Materials and methods: During a standard 3 port laparoscopic surgery samples peritoneal fluid, peritoneal brushings, and surgical smoke plum were collected. Specific real-time reverse transcriptase-polymerase chain reaction targeting SARS-CoV-2 were used to detect the presence of the virus in the samples.

Results: SARS-CoV-2 was not detected on multiple samples of the peritoneum in an asymptomatic patient.

Conclusions: SARS-CoV-2 was not found in the peritoneum of a single patient with asymptomatic infection. Further studies comparing SARS-CoV-2 surgical candidates are needed to address safety concerns.

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Conflict of interest statement

The author declares no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Laparoscopic sampling of the specimen. A, Sampling of the parietal peritoneum. B, Sampling of peritoneal fluid.
FIGURE 2
FIGURE 2
Aerosolized particles sampling. A, Three-way circuit was created using a stop-valve and a 20 mL syringe filled with 10 mL of normal saline along the Pneumoclear tubing. B, Smoke generated during the appendectomy. C and D, Smoke sampled using Pneumoclear.
FIGURE 3
FIGURE 3
SARS-CoV-2 results. Detected during nasal swab but not detected during the peritoneal sampling.
See this image and copyright information in PMC

References

    1. Pryor A. Sages and eaes recommendations regarding surgical response to covid-19 crisis 2020. Available at: https://www.sages.org/recommendations-surgical-response-covid-19/.
    1. Coccolini F, Tartaglia D, Puglisi A, et al. SARS-CoV-2 is present in peritoneal fluid in COVID-19 patients.pdf; 2020. Available at: lww.com/annalsofsurgery/Documents/SARS-CoV-2%20is%20present%20in%20perit... Accessed May 13, 2020. - PMC - PubMed
    1. Zheng MH, Boni L, Fingerhut A. Minimally invasive surgery and the novel coronavirus outbreak: lessons learned in China and Italy. Ann Surg. 2020. Doi: 10.1097/SLA.0000000000003924. - PMC - PubMed
    1. Ngaserin SH-N, Koh FH, Ong B-C, et al. COVID-19 not detected in peritoneal fluid: a case of laparoscopic appendicectomy for acute appendicitis in a COVID-19-infected patient. Langenbecks Arch Surg. 2020. Doi: 10.1007/s00423-020-01891-2. - PMC - PubMed
    1. COVID-19: Elective Case Triage Guidelines for Surgical Care. American College of Surgeons; 2020. Available at: www.facs.org/covid-19/clinical-guidance/elective-case. Accessed April 11, 2020.

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