Elective Surgery Management during Covid.
Dr. Vandana Soni, Laproscopic and metabolic Bariatric surgeon, Max Super Speciality Hospitals Saket, explains that surgeries that can be postponed for two or three weeks can also be postponed for two months. These are termed elective surgeries. Illustrating through examples Dr. Vandana Soni states that if a gall bladder stone in a patient has resulted in jaundice, it can be considered an emergency however, even in such cases an operation can be safely prevented through an endoscopy and inserting a stent, and the infection can be managed through medication. Similarly, cardiac surgery can be prevented through medical management, stenting, or angioplasty. The only concern with postponement is that if a patient experiences repeated pain or infections, then after a point the surgery becomes technically difficult. However, apart from this, there is no harm in postponing.
She explains that if a hospital is planning on starting with semi-emergencies or elective surgeries, they need to ensure that the following guidelines are strictly maintained:-
• The patient needs to complete their RT-PCR (Covid-19 test) ideally 48 hours before admission and surgery. This eliminates the fear of the patient being Covid-19 positive. Additionally, although medical personnel have been vaccinated, the entire medical staff and the caretakers of the patient need to be screened for Covid-19 from time to time to prevent any risk to the patient. Anyone who is even mildly symptomatic needs to be isolated.
• Secondly, the hospital needs to have a green corridor in place that permanently segregates the patients who are Covid-19 positive from those who have tested negative.
• Finally, the Covid-19 prevention guidelines need to be maintained:-
o Wearing a mask
o Ensuring that hand sanitizers are kept in numerous accessible places in the hospital
o Ensuring that the operation theatre is sanitized after every case
o Safely disposing of the equipment that the surgeons have been wearing