Precautions During Aerosolizing Procedures

Leanne Harling, cardiothoracic surgeon at Imperial College, UK, moderates a discussion with Tom Routledge, clinical lead at Guy's Hospital, London; Alberto Sandri, consultant surgeon at Ospedale San Luigi Gonzaga, Turin, Italy; Nirmal Kumar, lead ENT and consultant surgeon at Wrightington Wigan & Leigh NHS Foundation Trust; and Nigel Mercer, president of Federation of Surgical Specialty Association.

This roundtable is an interspecialty discussion about the heightened risks to the surgeon in the era of COVID-19. Through a collaboration with Otolaryngology and insights from the UK Federation of Surgical Specialty Association, we identify common areas of our practice that put us at heightened risk, as well as ways in which these may be mitigated. We discuss the situation in northern Italy, comparing and contrasting the UK experience to date, and what we may learn from them to best protect ourselves and our patients moving forwards.

In Part 1, topics discussed include general aspects, such as surgical case selection, modification of operative approach in the covid era, as well as outpatient follow-up protocols. In addition, we discuss procedure specific concerns, such as bronchoscopy and tracheostomy in covid and non-covid patients.

Part 2 focuses on minimal access approaches, use of surgical adjuncts, nodal dissection, pre-admission screening, and the management of post-operative drainage systems. We also discuss changes to the consent process and the need to accordingly modify operative risk estimates.