Risk of Air Contamination During Visceral Surgery in COVID19 Patients

University Hospital, Lille2 enrolled

Overview

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.

Study Type

INTERVENTIONAL

Allocation

Purpose

PREVENTION

Masking

NONE

Enrollment

Conditions

Sars-CoV2 Surgery COVID

Interventions

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

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

Outcomes

Primary Outcomes

Air contamination

Composite criteria: "50cm above the operating site" and/or "1m50 from the operating site" and/or "3m from the operating site"

Time frame: 10 minutes after incision if no opening of the digestive lumen, or 10 minutes after opening of the digestive tract

Secondary Outcomes

Environment contamination

Cartography of Sars-Cov2 environment surface contamination

Time frame: At the end of surgery, an average 1 hour 30 min

Surgical approach

Composite criteria: air contamination or environment contamination positivity rate according to surgical approach (laparoscopy or laparotomy)

Time frame: At the end of the intervention, an average 2 hours

Opening of the digestive tract

Composite criteria: air contamination or environment contamination positivity rate according to opening of digestive tract status (opened or not)

Time frame: At the end of the intervention,an average 2 hours

Biological fluids

Cartography of Sars-Cov2 presence in biological fluids (blood, stools, peritoneal fluid, digestive fluids, sputum, bile)

Time frame: During the procedure, an average 2 hours 30 min

Pneumoperitoneum

Presence of Sars-Cov 2 in pneumoperitoneum, evaluated on surgical smoke filter

Time frame: At the end of the procedure,an average 2 hours 30 min