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. 2021 Jul 1;274(1):50-56.
doi: 10.1097/SLA.0000000000004674.

International Delphi Expert Consensus on Safe Return to Surgical and Endoscopic Practice: From the Coronavirus Global Surgical Collaborative

Horacio J Asbun  1 , Mohammad Abu Hilal  2   3 , Filipe Kunzler  1 , Domenech Asbun  4 , Jaap Bonjer  5 , Kevin Conlon  6 , Nicolas Demartines  7 , Liane S Feldman  8 , Salvador Morales-Conde  9 , Andrea Pietrabissa  10 , Aurora D Pryor  11 , Christopher M Schlachta  12 , Patricia Sylla  13 , Eduardo M Targarona  14 , Yolanda Agra  15 , Marc G Besselink  5 , Mark Callery  16 , Sean P Cleary  17 , Luis De La Cruz  18 , Philippe Eckert  19 , Chad Evans  20 , Ho-Seong Han  21 , Daniel B Jones  16 , Tong Joo Gan  22 , Daniel Koch  23 , Keith D Lillemoe  24 , Davide Lomanto  25 , Jeffrey Marks  26 , Brent Matthews  27 , John Mellinger  28 , William Scott Melvin  29 , Eduardo Moreno-Paquentin  30 , Claudio Navarrete  31 , Timothy M Pawlik  32 , Patrick Pessaux  33 , Walter Ricciardi  34 , Steven Schwaitzberg  35 , Paresh Shah  36 , Joseph Szokol  37 , Mark Talamini  38 , Ricardo Torres  39 , Alessandro Triboldi  2 , Suthep Udomsawaengsup  40 , Federica Valsecchi  41 , Jean-Nicolas Vauthey  42 , Michael Wallace  43 , Steven D Wexner  44 , Michael Zinner  45 , Nader Francis  46
Affiliations

International Delphi Expert Consensus on Safe Return to Surgical and Endoscopic Practice: From the Coronavirus Global Surgical Collaborative

Horacio J Asbun et al. Ann Surg. .

Abstract

Objective: The aim of this work is to formulate recommendations based on global expert consensus to guide the surgical community on the safe resumption of surgical and endoscopic activities.

Background: The COVID-19 pandemic has caused marked disruptions in the delivery of surgical care worldwide. A thoughtful, structured approach to resuming surgical services is necessary as the impact of COVID-19 becomes better controlled. The Coronavirus Global Surgical Collaborative sought to formulate, through rigorous scientific methodology, consensus-based recommendations in collaboration with a multidisciplinary group of international experts and policymakers.

Methods: Recommendations were developed following a Delphi process. Domain topics were formulated and subsequently subdivided into questions pertinent to different aspects of surgical care in the COVID-19 crisis. Forty-four experts from 15 countries across 4 continents drafted statements based on the specific questions. Anonymous Delphi voting on the statements was performed in 2 rounds, as well as in a telepresence meeting.

Results: One hundred statements were formulated across 10 domains. The statements addressed terminology, impact on procedural services, patient/staff safety, managing a backlog of surgeries, methods to restart and sustain surgical services, education, and research. Eighty-three of the statements were approved during the first round of Delphi voting, and 11 during the second round. A final telepresence meeting and discussion yielded acceptance of 5 other statements.

Conclusions: The Delphi process resulted in 99 recommendations. These consensus statements provide expert guidance, based on scientific methodology, for the safe resumption of surgical activities during the COVID-19 pandemic.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Flowchart of the Delphi process. Numbers between boxes reflect the number of statements carried on to be voted on the next stage. The Expert Group includes members of the Steering Committee but excludes members of the Executive Committee.
FIGURE 2
FIGURE 2
Flowchart for patient tracking, in-hospital screening, and preoperative testing (statement reference number in parenthesis).
FIGURE 3
FIGURE 3
Flowchart and safety measures for staff in the perioperative setting (statement reference number in parenthesis).
See this image and copyright information in PMC

References

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