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  1. Artikel ; Online: Surgery in times of COVID-19-recommendations for hospital and patient management.

    Flemming, S / Hankir, M / Ernestus, R-I / Seyfried, F / Germer, C-T / Meybohm, P / Wurmb, T / Vogel, U / Wiegering, A

    Langenbeck's archives of surgery

    2020  Band 405, Heft 3, Seite(n) 359–364

    Abstract: ... cases of SARS-CoV-2 infected patients without compromising the care of emergency surgery and oncological ... of SARS-CoV-2 infected and surgical patient groups is key to preserving life while maintaining high ... surgical standards. Strictly segregating patient groups in emergency rooms, non-intensive care wards and ...

    Abstract Background: The novel coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has escalated rapidly to a global pandemic stretching healthcare systems worldwide to their limits. Surgeons have had to immediately react to this unprecedented clinical challenge by systematically repurposing surgical wards.
    Purpose: To provide a detailed set of guidelines developed in a surgical ward at University Hospital Wuerzburg to safely accommodate the exponentially rising cases of SARS-CoV-2 infected patients without compromising the care of emergency surgery and oncological patients or jeopardizing the well-being of hospital staff.
    Conclusions: The dynamic prioritization of SARS-CoV-2 infected and surgical patient groups is key to preserving life while maintaining high surgical standards. Strictly segregating patient groups in emergency rooms, non-intensive care wards and operating areas prevents viral spread while adequately training and carefully selecting hospital staff allow them to confidently and successfully undertake their respective clinical duties.
    Mesh-Begriff(e) Betacoronavirus ; COVID-19 ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Disease Transmission, Infectious/prevention & control ; Female ; Germany ; Hospitals, University ; Humans ; Infection Control/methods ; Male ; Outcome Assessment, Health Care ; Pandemics/prevention & control ; Pandemics/statistics & numerical data ; Patient Care/standards ; Patient Isolation ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; Practice Guidelines as Topic ; SARS-CoV-2 ; Surgical Procedures, Operative/standards
    Schlagwörter covid19
    Sprache Englisch
    Erscheinungsdatum 2020-05-08
    Erscheinungsland Germany
    Dokumenttyp Journal Article ; Review
    ZDB-ID 1423681-3
    ISSN 1435-2451 ; 1435-2443
    ISSN (online) 1435-2451
    ISSN 1435-2443
    DOI 10.1007/s00423-020-01888-x
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  2. Artikel ; Online: Surgery in times of COVID-19—recommendations for hospital and patient management

    Flemming, S. / Hankir, M. / Ernestus, R.-I. / Seyfried, F. / Germer, C.-T. / Meybohm, P. / Wurmb, T. / Vogel, U. / Wiegering, A.

    Langenbeck's Archives of Surgery

    2020  Band 405, Heft 3, Seite(n) 359–364

    Schlagwörter Surgery ; covid19
    Sprache Englisch
    Verlag Springer Science and Business Media LLC
    Erscheinungsland us
    Dokumenttyp Artikel ; Online
    ZDB-ID 1423681-3
    ISSN 1435-2451 ; 1435-2443
    ISSN (online) 1435-2451
    ISSN 1435-2443
    DOI 10.1007/s00423-020-01888-x
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  3. Artikel: Surgery in times of COVID-19-recommendations for hospital and patient management

    Flemming, S / Hankir, M / Ernestus, R-I / Seyfried, F / Germer, C-T / Meybohm, P / Wurmb, T / Vogel, U / Wiegering, A

    Langenbecks Arch Surg

    Abstract: ... cases of SARS-CoV-2 infected patients without compromising the care of emergency surgery and oncological ... CoV-2 infected and surgical patient groups is key to preserving life while maintaining high surgical ... standards. Strictly segregating patient groups in emergency rooms, non-intensive care wards and operating ...

    Abstract BACKGROUND: The novel coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has escalated rapidly to a global pandemic stretching healthcare systems worldwide to their limits. Surgeons have had to immediately react to this unprecedented clinical challenge by systematically repurposing surgical wards. PURPOSE: To provide a detailed set of guidelines developed in a surgical ward at University Hospital Wuerzburg to safely accommodate the exponentially rising cases of SARS-CoV-2 infected patients without compromising the care of emergency surgery and oncological patients or jeopardizing the well-being of hospital staff. CONCLUSIONS: The dynamic prioritization of SARS-CoV-2 infected and surgical patient groups is key to preserving life while maintaining high surgical standards. Strictly segregating patient groups in emergency rooms, non-intensive care wards and operating areas prevents viral spread while adequately training and carefully selecting hospital staff allow them to confidently and successfully undertake their respective clinical duties.
    Schlagwörter covid19
    Verlag WHO
    Dokumenttyp Artikel
    Anmerkung WHO #Covidence: #209715
    Datenquelle COVID19

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  4. Artikel ; Online: Surgery Scheduling and Perioperative Care

    John S. F. Lyons / Mehmet A. Begen / Peter C. Bell

    Analytics, Vol 2, Iss 36, Pp 656-

    Smoothing and Visualizing Elective Surgery and Recovery Patient Flow

    2023  Band 675

    Abstract: ... through a multi-stage perioperative system and use characteristics of surgery type and surgeon booking times ... to predict time intervals for patient procedures and subsequent recoveries. Working with a hospital ... especially timely given high surgical wait times in Ontario which even got worse due to the COVID-19 pandemic. ...

    Abstract This paper addresses the practical problem of scheduling operating room (OR) elective surgeries to minimize the likelihood of surgical delays caused by the unavailability of capacity for patient recovery in a central post-anesthesia care unit (PACU). We segregate patients according to their patterns of flow through a multi-stage perioperative system and use characteristics of surgery type and surgeon booking times to predict time intervals for patient procedures and subsequent recoveries. Working with a hospital in which 50+ procedures are performed in 15+ ORs most weekdays, we develop a constraint programming (CP) model that takes the hospital’s elective surgery pre-schedule as input and produces a recommended alternate schedule designed to minimize the expected peak number of patients in the PACU over the course of the day. Our model was developed from the hospital’s data and evaluated through its application to daily schedules during a testing period. Schedules generated by our model indicated the potential to reduce the peak PACU load substantially, 20-30% during most days in our study period, or alternatively reduce average patient flow time by up to 15% given the same PACU peak load. We also developed tools for schedule visualization that can be used to aid management both before and after surgery day; plan PACU resources; propose critical schedule changes; identify the timing, location, and root causes of delay; and to discern the differences in surgical specialty case mixes and their potential impacts on the system. This work is especially timely given high surgical wait times in Ontario which even got worse due to the COVID-19 pandemic.
    Schlagwörter OR scheduling ; constraint programming ; load levelling ; Electronic computers. Computer science ; QA75.5-76.95 ; Probabilities. Mathematical statistics ; QA273-280
    Sprache Englisch
    Erscheinungsdatum 2023-08-01T00:00:00Z
    Verlag MDPI AG
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  5. Artikel ; Online: Cardiothoracic robotic assisted surgery in times of COVID-19.

    Van den Eynde, Jef / De Groote, Senne / Van Lerberghe, Robin / Van den Eynde, Raf / Oosterlinck, Wouter

    Journal of robotic surgery

    2020  Band 14, Heft 5, Seite(n) 795–797

    Abstract: ... available for cardiothoracic robotic assisted surgery in COVID-19 positive patients. Here, we discuss ... robotic assisted surgery for cardiothoracic indications in patients with confirmed COVID-19. It is ... the remaining procedures on COVID-19 positive patients can be performed safely, it is important to consider ...

    Abstract The coronavirus disease 2019 (COVID-19) pandemic poses an immense threat to healthcare systems worldwide. At a time when elective surgeries are being suspended and questions are being raised about how the remaining procedures on COVID-19 positive patients can be performed safely, it is important to consider the potential role of robotic assisted surgery within the current pandemic. Recently, several robotic assisted surgery societies have issued their recommendations. To date, however, no specific recommendations are available for cardiothoracic robotic assisted surgery in COVID-19 positive patients. Here, we discuss the potential risks, benefits, and preventive measures that need to be taken into account when considering robotic assisted surgery for cardiothoracic indications in patients with confirmed COVID-19. It is suggested that robotic assisted surgery might have various advantages such as early recovery after surgery, shorter hospital stay, and reduced loss of blood and fluids as well as smaller incisions. However, electrosurgical and ultrasonic devices, as well as CO2 insufflation should be managed with caution to prevent the risk of aerosolization of viral particles.
    Mesh-Begriff(e) COVID-19 ; Cardiac Surgical Procedures/methods ; Cardiac Surgical Procedures/statistics & numerical data ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Cross Infection/prevention & control ; Elective Surgical Procedures/methods ; Elective Surgical Procedures/statistics & numerical data ; Female ; Humans ; Infection Control/organization & administration ; Length of Stay ; Male ; Occupational Health/statistics & numerical data ; Outcome Assessment, Health Care ; Pandemics/prevention & control ; Pandemics/statistics & numerical data ; Patient Safety ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; Robotic Surgical Procedures/methods ; Robotic Surgical Procedures/statistics & numerical data
    Schlagwörter covid19
    Sprache Englisch
    Erscheinungsdatum 2020-05-08
    Erscheinungsland England
    Dokumenttyp Journal Article ; Review
    ZDB-ID 2268283-1
    ISSN 1863-2491 ; 1863-2483
    ISSN (online) 1863-2491
    ISSN 1863-2483
    DOI 10.1007/s11701-020-01090-7
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  6. Artikel ; Online: Awake Rhinology Surgery in Response to the COVID-19 Pandemic in Europe.

    Andrews, Peter / Anschuetz, Lukas / Baptista, Peter M / Bast, Florian / Beule, Achim G / De Carpentier, John / Fitzgerald, Deirdre / Furtado, Luis Miguel Pinto Correia / Knox, Barton / Marzetti, Andrea / Perkins, Nora W / Randhawa, Prem Singh

    ORL; journal for oto-rhino-laryngology and its related specialties

    2021  Band 84, Heft 2, Seite(n) 93–102

    Abstract: ... surgery. Feedback was analysed and shared to develop a consensus of best practice.: Recommendations ... the suspension of routine surgery during the COVID-19 crisis. Routine rhinology surgery under general anaesthetic ... 19 recovery phase, ensuring patients are treated in a timely matter, thereby avoiding higher ...

    Abstract Background: European health-care systems are faced with a backlog of surgical procedures following the suspension of routine surgery during the COVID-19 crisis. Routine rhinology surgery under general anaesthetic (GA) is now faced with significant challenges which include limited theatre capacity, the negative ramifications of surgical prioritization, reduced patient throughput in secondary care, and additional personal protective equipment requirements. Delayed surgery in rhinology, particularly with regards to chronic rhinosinusitis, has previously been shown to have poorer surgical outcomes, a detrimental effect on quality of life and long-term negative health socio-economic effects. Awake rhinology surgery under local anaesthetic (LA) provides an ideal alternative to GA. It provides a means of operating on patients in a setting alternative to currently oversubscribed main theatres, by utilizing satellite facilities, while ensuring identical surgical outcomes for patients who may otherwise have been forced to wait a long time for their procedure. It also confers additional benefits in terms of shorter recovery time and hospital stay for patients.
    Objectives: We have developed a set of recommendations that are intended to help support clinicians and managers to better adopt LA rhinology protocols and minimize the risk to the patient and health-care professionals involved.
    Methodology: International roundtable forums were conducted and supplemented by individual interviews. The international board consisted of 12 rhinologists experienced in awake rhinology surgery. Feedback was analysed and shared to develop a consensus of best practice.
    Recommendations: Local and national guidelines need to be adhered to with specific focus on patient and clinician safety. When performing awake rhinology procedures in the COVID-19 recovery process, consider implementing specific safety measures and workflow practices to safeguard patients and staff and minimize the risk of infection.
    Conclusion: Awake surgery potentially provides quicker access to routine rhinology surgery in the post-COVID-19 recovery phase, ensuring patients are treated in a timely matter, thereby avoiding higher downstream costs, and improving outcomes.
    Mesh-Begriff(e) COVID-19 ; Europe ; Humans ; Otorhinolaryngologic Surgical Procedures/methods ; Pandemics/prevention & control ; Rhinitis/surgery ; Sinusitis/surgery ; Wakefulness
    Sprache Englisch
    Erscheinungsdatum 2021-08-31
    Erscheinungsland Switzerland
    Dokumenttyp Journal Article ; Review
    ZDB-ID 121482-2
    ISSN 1423-0275 ; 0301-1569
    ISSN (online) 1423-0275
    ISSN 0301-1569
    DOI 10.1159/000517155
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  7. Artikel ; Online: Paediatric surgery and COVID-19: urgent lessons to be learned.

    Turner, Alexander M / Albolino, Sara / Morabito, Antonino

    International journal for quality in health care : journal of the International Society for Quality in Health Care

    2020  Band 33, Heft 1

    Abstract: ... learned from the frontline 'on the fly' during COVID-19 emergency should be consolidated and taken ... surgeons in Italy and the UK, representing both peak and pre-peak infective time zones, were able ... Background: The dissemination of scientific data on coronavirus disease 2019 (COVID-19 ...

    Abstract Background: The dissemination of scientific data on coronavirus disease 2019 (COVID-19) continually builds but, in April 2020, could not keep up with the spread of the disease. Through technology, surgeons in Italy and the UK, representing both peak and pre-peak infective time zones, were able to communicate so that the urgent lessons on the huge expected demands of care learned in Italy could be brought to the UK in advance. This paper specifically discusses the issues related to paediatric surgery, currently under-reported in the literature.
    Methods: The aim of this paper is to conjoin experience from the field to provide a framework for a safe assessment and treatment of paediatric patients by adopting a systemic approach aimed at reducing the risk of contamination. We reviewed the processes and good practices that were undertaken in contexts of emergency such as in Italy and the UK and then adapted them within the Systems Engineering Initiative for Patient Safety (SEIPS) framework to provide an assessment of how to reorganize the services in order to cope with an unexpected situation. The SEIPS model is the adopted theoretical framework, which allows to analyse the system in its main components with a human factors and ergonomics (HFE) perspective.
    Results: The results introduce some of the good practices and recommendations developed during the emergency in the surgical scenario with a focus on the paediatric patients. They represent the lessons learned from the combination of the little existing evidence of literature and the experience from surgical teams who responded in an impromptu and unrehearsed way.
    Conclusions: Lessons learned from the frontline 'on the fly' during COVID-19 emergency should be consolidated and taken into the future. In order to prepare proactively for the next phases and get ahead of the curve of these hospital accesses, there is a need for a risk assessment of the new clinical pathways with a multidisciplinary approach centred on HFE with the adoption of the SEIPS model and an involvement of all the surgical teams.
    Mesh-Begriff(e) COVID-19/epidemiology ; Child ; Ergonomics ; Humans ; Infection Control/methods ; Italy/epidemiology ; Models, Theoretical ; Patient Safety ; Risk Management ; SARS-CoV-2 ; Surgical Procedures, Operative ; United Kingdom/epidemiology
    Sprache Englisch
    Erscheinungsdatum 2020-12-07
    Erscheinungsland England
    Dokumenttyp Journal Article
    ZDB-ID 1194150-9
    ISSN 1464-3677 ; 1353-4505
    ISSN (online) 1464-3677
    ISSN 1353-4505
    DOI 10.1093/intqhc/mzaa149
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  8. Artikel ; Online: Preoperative Evaluation and Timing of Surgery for Adult Patients After COVID-19 Infection

    Peking Union Medical College Hospital

    Xiehe Yixue Zazhi, Vol 14, Iss 2, Pp 266-

    Recommendations of Peking Union Medical College Hospital (2023)

    2023  Band 270

    Abstract: ... preoperative evaluation and timing of surgery for patients after COVID-19 infection. The recommendations ... disease of 2019(COVID-19), the preoperative evaluation and timing of surgery for patients after COVID-19 ... from COVID-19 and surgery/procedure should take into account of patients' underlying health conditions ...

    Abstract With the adjustment of China's epidemic prevention and control guidelines regarding coronavirus disease of 2019(COVID-19), the preoperative evaluation and timing of surgery for patients after COVID-19 infection have become the focus of attention for both healthcare workers and patients. Based on the latest study and related clinical experience, Peking Union Medical College Hospital (PUMCH) has therefore compiled this multidisciplinary, evidence-based recommendation for concise, individualized, and practical preoperative evaluation and timing of surgery for patients after COVID-19 infection. The recommendations emphasize patients' COVID-19 infection history, the severity of symptoms, and medical/physiologic recovery status during preoperative evaluation. The determination of appropriate length of time between recovery from COVID-19 and surgery/procedure should take into account of patients' underlying health conditions, the severity of the COVID-19 infection course, and the types of surgery and anesthesia scheduled, to minimize postoperative complications. The recommendations are intended to aid healthcare workers in evaluating these patients, scheduling them for the optimal timing of surgery, and optimizing perioperative management and postoperative recovery.
    Schlagwörter covid-19 ; preoperative evaluation ; timing of surgery ; Medicine ; R
    Thema/Rubrik (Code) 616
    Sprache Chinesisch
    Erscheinungsdatum 2023-03-01T00:00:00Z
    Verlag Editorial Office of Medical Journal of Peking Union Medical College Hospital
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  9. Artikel ; Online: Intrapandemic regional anesthesia as practice: a historical cohort study in patients undergoing breast cancer surgery.

    Clairoux, Ariane / Soucy-Proulx, Maxim / Pretto, François / Courgeon, Victoria / Caron-Goudreau, Maxime / Issa, Rami / Bélanger, Marie-Ève / Brulotte, Véronique / Verdonck, Olivier / Idrissi, Moulay / Fortier, Annik / Richebé, Philippe

    Canadian journal of anaesthesia = Journal canadien d'anesthesie

    2022  Band 69, Heft 4, Seite(n) 485–493

    Abstract: ... With growing surgical wait times, concerns related to aerosol-generating procedures, and recommendations ... because of the virus's impact on traditional anesthetic management. Novel protocols, developed to protect patients and ... to review files of consecutive patients who underwent breast cancer surgery between 30 March 2020 and 30 ...

    Titelübersetzung L’anesthésie régionale en tant que pratique intrapandémique : une étude de cohorte historique chez des patientes bénéficiant d’une chirurgie de cancer du sein.
    Abstract Background: The COVID-19 pandemic has markedly increased delays in oncologic surgeries because of the virus's impact on traditional anesthetic management. Novel protocols, developed to protect patients and medical professionals, have altered the ways and instances in which general anesthesia (GA) can be safely performed. To reduce virus exposure related to aerosol-generating procedures, it is now recommended to avoid GA when feasible and promote regional anesthesia instead. At our institution, we observed faster postoperative recovery in patients who received paravertebral blocks for breast cancer surgery instead of GA. This led us to formally evaluate whether regional anesthesia instead of GA helped improve time to hospital discharge.
    Methods: We conducted a historical cohort study to retrospectively analyze two cohorts of patients: prepandemic vs intrapandemic. We obtained approval from our institutional ethics committee to review files of consecutive patients who underwent breast cancer surgery between 30 March 2020 and 30 June 2020 (intrapandemic group; N = 106) and consecutive patients-moving backwards-from 28 February 2020 to 6 December 2019 (prepandemic group; N = 104). The primary outcome was the length of time between the end of surgery to readiness for hospital discharge. Secondary outcomes included the incidence of postoperative nausea and vomiting (PONV), the need for postoperative analgesia, and the duration of stay in the postanesthesia care unit (PACU).
    Results: The median [interquartile range (IQR)] time to readiness for hospital discharge was significantly lower in patients who received paravertebral blocks for breast cancer surgery compared with GA (intrapandemic group, 119 [99-170] min vs prepandemic group, 191 [164-234] min; P < 0.001) as was the incidence of PONV (3% vs 11%; P = 0.03) and median [IQR] PACU durations of stay (29 [21-39] min vs 46 [37-63] min; P < 0.001).
    Conclusions: Patients who received paravertebral blocks for breast cancer surgery in the intrapandemic group were ready for hospital discharge earlier, spent less time in the PACU, and experienced less PONV than those who received GA in the prepandemic group. With growing surgical wait times, concerns related to aerosol-generating procedures, and recommendations to avoid GA when feasible, paravertebral blocks as the principal anesthetic modality for breast cancer surgery offered benefits for patients and medical teams.
    Mesh-Begriff(e) Anesthesia, Conduction/adverse effects ; Anesthesia, General/methods ; Breast Neoplasms/complications ; Breast Neoplasms/epidemiology ; Breast Neoplasms/surgery ; COVID-19 ; Cohort Studies ; Female ; Humans ; Pain, Postoperative/epidemiology ; Pandemics ; Retrospective Studies
    Sprache Englisch
    Erscheinungsdatum 2022-01-07
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 91002-8
    ISSN 1496-8975 ; 0832-610X
    ISSN (online) 1496-8975
    ISSN 0832-610X
    DOI 10.1007/s12630-021-02182-0
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  10. Artikel: Cardiothoracic robotic assisted surgery in times of COVID-19

    Van den Eynde, Jef / De Groote, Senne / Van Lerberghe, Robin / Van den Eynde, Raf / Oosterlinck, Wouter

    J Robot Surg

    Abstract: ... available for cardiothoracic robotic assisted surgery in COVID-19 positive patients. Here, we discuss ... robotic assisted surgery for cardiothoracic indications in patients with confirmed COVID-19. It is ... the remaining procedures on COVID-19 positive patients can be performed safely, it is important to consider ...

    Abstract The coronavirus disease 2019 (COVID-19) pandemic poses an immense threat to healthcare systems worldwide. At a time when elective surgeries are being suspended and questions are being raised about how the remaining procedures on COVID-19 positive patients can be performed safely, it is important to consider the potential role of robotic assisted surgery within the current pandemic. Recently, several robotic assisted surgery societies have issued their recommendations. To date, however, no specific recommendations are available for cardiothoracic robotic assisted surgery in COVID-19 positive patients. Here, we discuss the potential risks, benefits, and preventive measures that need to be taken into account when considering robotic assisted surgery for cardiothoracic indications in patients with confirmed COVID-19. It is suggested that robotic assisted surgery might have various advantages such as early recovery after surgery, shorter hospital stay, and reduced loss of blood and fluids as well as smaller incisions. However, electrosurgical and ultrasonic devices, as well as CO2 insufflation should be managed with caution to prevent the risk of aerosolization of viral particles.
    Schlagwörter covid19
    Verlag WHO
    Dokumenttyp Artikel
    Anmerkung WHO #Covidence: #209449
    Datenquelle COVID19

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