Safe evacuation system for pneumoperitoneum and surgical smoke in laparoscopic surgery using a water trap in times of COVID-19

Abstract

Introduction: The recent SARS-CoV-2 (COVID-19) pandemics has raised concern on the incidental exposition of health team to air transmissible infectious agents during surgeries. The main goal of this work is to communicate a simple and low-cost filtering system allowing to reduce the risk of contagion related to the virus, associated with pneumoperitoneum removal during surgical laparoscopy. Methods: A closed circuit of gas removal and filtering was developed and implemented in laparoscopic gynecologic procedures at a tertiary teaching hospital. The circuit included an HEPA (High Efficiency Particulate Air) filter and a vacuum trap containing an inactivating solution based on quaternary ammonium or sodium hypochlorite. Results: Since its introduction, seventeen laparoscopic surgeries have been carried out for different gynecologic pathologies. Two of them in Covid (+) cases. To date, no contagion has been reported among health teammates participating in these surgeries. Conclusions: It is possible to implement a pneumoperitoneum evacuation system in laparoscopic surgery presumably effective in minimizing the risk of exposure to the SARS-COV-2 virus (Covid- 19). Its low cost makes it especially recommended in developing countries.