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Meta-Analysis
. 2021 Jun;406(4):1007-1014.
doi: 10.1007/s00423-021-02142-8. Epub 2021 Mar 6.

Laparoscopic surgery during the COVID-19 pandemic: detection of SARS-COV-2 in abdominal tissues, fluids, and surgical smoke

Isaac Cheruiyot  1 , Prabjot Sehmi  2 , Brian Ngure  2 , Musa Misiani  2 , Paul Karau  3 , Beda Olabu  2 , Brandon Michael Henry  4 , Giuseppe Lippi  5 , Roberto Cirocchi  6 , Julius Ogeng'o  2
Affiliations
Meta-Analysis

Laparoscopic surgery during the COVID-19 pandemic: detection of SARS-COV-2 in abdominal tissues, fluids, and surgical smoke

Isaac Cheruiyot et al. Langenbecks Arch Surg. 2021 Jun.

Abstract

Background: There are still concerns over the safety of laparoscopic surgery in coronavirus disease 2019 (COVID-19) patients due to the potential risk of viral transmission through surgical smoke/laparoscopic pneumoperitoneum.

Methods: We performed a systematic review of currently available literature to determine the presence of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) in abdominal tissues or fluids and in surgical smoke.

Results: A total of 19 studies (15 case reports and 4 case series) comprising 29 COVID-19 patients were included. The viral RNA was positively identified in 11 patients (37.9%). The samples that tested positive include the peritoneal fluid, bile, ascitic fluid, peritoneal dialysate, duodenal wall, and appendix. Similar samples, together with the omentum and abdominal subcutaneous fat, tested negative in the other patients. Only one study investigated SARS-COV-2 RNA in surgical smoke generated during laparoscopy, reporting negative findings.

Conclusions: There are conflicting results regarding the presence of SARS-COV-2 in abdominal tissues and fluids. No currently available evidence supports the hypothesis that SARS-COV-2 can be aerosolized and transmitted through surgical smoke. Larger studies are urgently needed to corroborate these findings.

Keywords: COVID-19; Surgery; Surgical smoke.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow of studies through the meta-analysis
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