Postoperative Assessment of Nosocomial Transmission of COVID-19 after Robotic Surgical Procedures during the Pandemic

Highlights • SARS-Cov2 contamination evaluation for robotic oncological surgery at the beginning of the pandemic • With strict screening and protective protocol, low post-operative contamination rate was observed • No life-threatening condition was observed for positive patient • COVID-19 contamination among surgical team was not observed • Robotic surgery seemed safe and adequate regarding COVID-19 transmission risk
Objectives To assess potential nosocomial COVID-19 transmission in patients who underwent robot-assisted laparoscopic procedures during the pandemic. Material and methods Prospective study in patients undergoing robot-assisted laparoscopy in urology or gynaecology within two academic hospitals. Patients underwent local preoperative COVID-19 screening using a symptoms questionnaire. Patients with suspicious screening underwent coronavirus RT-PCR and were excluded from robotic surgery if positive. Patients with symptoms post-surgery were systematically tested for coronavirus by RT-PCR. One month post-surgery, all patients had a telephone consultation to evaluate COVID-19 symptoms. Results Sixty-eight patients underwent robotic surgery during the study period (median age: 63-years [IQR: 53-70], 1.8 male: female ratio). Oncology was the main indication for robotic surgery (n=62, 91.2%) and 26 patients (38.2%) received a chest CT-scan prior to surgery. Eleven patients (16.2%) were symptomatic after surgery of whom only one tested positive for coronavirus by RT-PCR (1.5%) and was transferred to COVID-19 unit with no life-threatening condition. No attending surgeon was diagnosed with COVID-19 during the study. Conclusions Robot-assisted laparoscopic surgery seemed safe in the era of COVID-19 as long as all recommended precautions are followed. The rate of nosocomial COVID-19 transmission was extremely low despite the fact that we only used RT-PCR testing in symptomatic patients during the preoperative work-up. Larger cohort is needed to validate these results.