Released: 7/10/2020 12:52:38 PM
Published July 10, 2020
“The popular term ‘elective surgery’ really means scheduled surgery,” said Dr. Kevin Gibbons, executive director of the UBMD Physicians Group and chief of neurosurgery with Kaleida Health. “Many of these procedures are medically necessary and time-sensitive. If you have a pinched nerve in your neck and it's causing significant pain, that's one thing. But if it's causing significant weakness in your dominant arm, that's another thing, especially if that weakness could become permanent if you're not treated in the appropriate time frame.”
Gibbons, whose neurosurgery practice is limited by his other duties – including his role as senior associate dean for clinical affairs in the University at Buffalo Jacobs School of Medicine and Biomedical Sciences – postponed 70 procedures before scheduled surgeries could resume. He has lengthened his surgery days to address the backlog. Outpatient surgeries at Buffalo General Medical Center, where he performs most of them, are back at 90% of pre-Covid volume, he said.
“The big issue is getting patients ready,” Gibbons said. “It’s not like throwing a switch. A lot of patients had preoperative testing done previously, and it needs to be repeated.”
That might include diagnostic imaging and will entail blood work which now must include a test within five days of scheduled surgery for the presence of novel coronavirus – followed by self-quarantine of patients until their procedures take place.
Those patients will need to arrive on surgery day wearing a mask. They will undergo a temperature check and health screening after they bid goodbye in the parking lot to the people who drove them, who won’t see them again until it’s time to go home.
Every staff member will wear personal protective equipment. Sanitizing will be obvious.
Outpatient surgery centers have established similar guidelines to protect patients and staff from Covid-19. Among them:
Testing: Patients are required to get a test for the novel coronavirus three to five days before a scheduled surgery and self-quarantine until after their procedure.
Screening: Staff and patients will have their temperature taken, be asked if they have any symptoms of Covid-19 or have visited any regions during recent weeks that have become coronavirus disease hot spots.
Other protection: Plastic shields separate patients from staff at check-in. Those waiting for surgery can do so outside or by socially distancing inside. All staff is required to wear masks and other personal protective equipment. Patients are required to wear facial coverings, as well.
Limited access: Those driving friends or loved ones to scheduled procedures can expect to wait outside in their vehicles or a nearby location until patients are ready to go home. The drivers will be notified with a text or phone call at that time.
Disinfecting: Surgical suites and recovery bays will be thoroughly cleaned after every use, as has always been the case.
Office visits: Some preoperative and postoperative visits may be done through telehealth but expect preparative imaging and blood testing, as well as at least one postoperative visit to be conducted in person in places where similar Covid-prevention protocols also are in place. “We typically need to see patients at least once to examine them and particularly their incisions,” Gibbons said. “There are certain things that we can really only test by physically examining the patient, checking reflexes and looking for other problems that you can't do over the phone.”