The Risk for SARS-Cov-2 Virus Contamination through Surgical Smoking and Aerosolization by Laparoscopic Surgery: A Systematic Review

Abstract

Laparoscopic surgery is one of the risky procedures due to exposing operating team to aerosols. In fact, aerosol exposure may occur in different steps to perform the operation including intentional or unintentional CO2 releasing mainly during insertion or removal of ports, retrieving specimens or removing pneumoperitoneum at the end of operation. High rates of other pathogens such as hepatitis B virus, human immunodeficiency virus, and human papillomavirus in smokes and aerosols generated by laparoscopic devices have been reported, but there is no strong evidence of an increased risk of transmitting the SARS-CoV-2 virus through laparoscopic surgery. The present study aimed to systematically review the literature with respect to safety of laparoscopic and minimally invasive surgeries during Covid-19 pandemic with respect to the risk of viral contamination through surgical smoking and aerosolization, and then to summarize the delivered recommendations for smoke evacuation and aerosol production control during Covvid-19 outbreak.