COVID, Sars-CoV2, Surgery
Conditions
Keywords
COVID-19, visceral surgery, air contamination, laparoscopy, prevention, prevention
Brief summary
Sars-Cov2 has been found in the digestive tract, as well as the respiratory tract. Protection of health care workers during surgery has been increased and some guidelines advocate for abandoning laparoscopy in COVID19 patients for fear of contamination, evenghtough this does not benefit the patient. However, Sars-Cov2 contamination risk during visceral surgery remains unknown. Inadequate protection is unnecessary costful and can be inefficient if too binding. Our hypotheses are that 1) Sars-Cov 2 can travel through droplet and air during visceral surgery. 2) Laparoscopy, because of the pneumoperitoneum and its leaks, warrant more air contamination whereas laparotomy warrant more droplet contamination, which would justified increased protection.
Interventions
OTHERCartography of air contamination, environment contamination and biological fluid by Sars-Cov2 during visceral surgery in COVID19 patients.
Air sampling, operating room surfaces sampling and patients' biological fluid sampling for Sars-Cov2 quantification
Sponsors
University Hospital, Lille
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
COVID19 patients undergoing visceral surgery
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Documented Sars-Cov2 infection (nasopharyngeal swab, tracheal sampling, thoracic CT, serology) * Need of visceral surgery (laparoscopy or laparotomy) * Signed informed consent * Social coverage * Patient who agrees to be included in the study and who signs the informed consent form * Patient affiliated to a healthcare insurance plan * Patient willing to comply with study's requirements
Exclusion criteria
* Need of another type of surgery during the same procedure * Mentally unbalanced patients, under supervision or guardianship * Patient who does not understand French/ is unable to give consent * Patient not affiliated to a French or European healthcare insurance * Patient incarcerated
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Air contamination | 10 minutes after incision if no opening of the digestive lumen, or 10 minutes after opening of the digestive tract | Composite criteria: 50cm above the operating site and/or 1m50 from the operating site and/or 3m from the operating site |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Environment contamination | At the end of surgery, an average 1 hour 30 min | Cartography of Sars-Cov2 environment surface contamination |
| Surgical approach | At the end of the intervention, an average 2 hours | Composite criteria: air contamination or environment contamination positivity rate according to surgical approach (laparoscopy or laparotomy) |
| Opening of the digestive tract | At the end of the intervention,an average 2 hours | Composite criteria: air contamination or environment contamination positivity rate according to opening of digestive tract status (opened or not) |
| Biological fluids | During the procedure, an average 2 hours 30 min | Cartography of Sars-Cov2 presence in biological fluids (blood, stools, peritoneal fluid, digestive fluids, sputum, bile) |
| Pneumoperitoneum | At the end of the procedure,an average 2 hours 30 min | Presence of Sars-Cov 2 in pneumoperitoneum, evaluated on surgical smoke filter |
Countries
France
Outcome results
None listed