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. 2020 Apr 3;223(1):85.e1–85.e19. doi: 10.1016/j.ajog.2020.03.038

Supplementary Table.

General guidance to assist surgeons and hospital leaders with staged cancellation or postponement of surgical cases in response to the COVID-19 pandemic. Individual case-specific characteristics may modify category assignment for a given patient. The surgical services available at any individual health center will vary. This table is intended as a guide and could be expanded or modified for use in any individual hospital

Category I II III IV V
Trigger(s) to cancel or delay
  • -

    Community transmission
  • -

    Community transmission

  • -

    Inpatient bed availability limited

  • -

    PPE supply limited
  • -

    Community transmission

  • -

    Inpatient bed availability limited

  • -

    Case-by-case basis with team review
  • -

    Community transmission

  • -

    PPE supply limited
  • -

    Never canceled
COVID-19 morbidity and mortality risk High Average Average Average All risk levels
Urgency level Low Low Moderate (can delay up to 14 d) Low High
Impact on bed capacity Variable by procedure (possible inpatient) Variable by procedure (possible inpatient) Variable by procedure (possible inpatient) No impact (same-day surgery) High (inpatient, emergency department)
Examples of patient characteristics and/or surgical case types
General surgery

For all surgical groups

  • -

    Immunocompromised

  • -

    Elderly (older than 70 y)

  • -

    Respiratory disease

  • -

    Other comorbidities (as specifically listed)
  • -

    Excision of benign mass

  • -

    Joint replacement

  • -

    Cosmetic procedures
  • -

    Excision of malignant mass

  • -

    Cardiac catheterization for stable angina

  • -

    Fixation of closed orthopedic injury
  • -

    Day-stay surgeries

  • -

    Surgical centers

  • -

    Procedures on patients already admitted, allowing for immediate discharge
  • -

    Emergent trauma or acute abdomen (hemorrhage)

  • -

    Required surgical intervention for infection

  • -

    Spinal cord decompression

  • -

    Transplants

  • -

    Cardiac catheterization for acute myocardial infarction

  • -

    Procedures on ICU patients (open abdomen, PEG, tracheostomy)
Burn surgery
  • -

    Release of burn scar contractures in cases without impending functional compromise from contracture
  • -

    Release of burn scar contractures in cases with impending functional compromise from contracture
  • -

    Laser-based fractional ablation of hypertrophic scars

  • -

    Scar revision and release of burn scar contractures (when deemed feasible as an outpatient surgery)
  • -

    Excision/debridement, preparation, and coverage of burns or wound beds

  • -

    Amputation

  • -

    Tracheostomy for high-risk airways or to facilitate wound treatment
Breast, melanoma
  • -

    Lymph node dissection

  • -

    Total thyroidectomy/bilateral neck dissection

  • -

    Mastectomy

  • -

    Adrenalectomy
  • -

    Excision of benign mass

  • -

    Partial mastectomy

  • -

    Parathyroidectomy

  • -

    Thyroid lobectomy
  • -

    Breast abscess

  • -

    Sarcoma that has received radiation therapy
Colorectal
  • -

    AIN/condyloma cases (impacts N95 mask supply)
  • -

    Nonurgent benign anorectal cases requiring inpatient stay

  • -

    Pelvic floor repair (rectal prolapse, etc)
  • -

    Intestinal resection for cancer, diverticulitis, and inflammatory bowel disease
  • -

    Nonurgent benign anorectal cases usually treated as outpatient (excluding AIN/condyloma)

  • -

    Sacral nerve stimulator for incontinence

  • -

    Colonoscopy
  • -

    Urgent/emergent intestinal surgery for perforation or obstruction

  • -

    Urgent/emergent anorectal cases: abscess, incarcerated prolapse, and necrotizing infections of the perineum
Minimally invasive
  • -

    Antireflux procedures in lung transplant patients
  • -

    Elective incisional hernia repair

  • -

    Antireflux procedures

  • -

    Bariatric procedures
  • -

    Repair of symptomatic hernias

  • -

    Cancer resection

  • -

    Surgical procedures for severe nutritional depletion
  • -

    Groin hernia repair

  • -

    Endoscopy
  • -

    Urgent/emergent intestinal surgery for perforation, obstruction
Pancreas, biliary
  • -

    Symptomatic incisional hernia
  • -

    Chronic pancreatitis
  • -

    Pancreas cancer

  • -

    Liver metastasis

  • -

    Symptomatic incisional hernia
  • -

    Biliary colic

  • -

    Biliary pancreatitis
  • -

    Patients with cancer receiving neoadjuvant therapy where surgical timing is driven by radiation treatment
Plastics
  • -

    Reconstruction of existent, nonfunctional conditions: delayed breast reconstruction, chronic wounds, and facial palsy free flaps
  • -

    Cleft palate surgery

  • -

    Craniosynostosis
  • -

    Breast reduction

  • -

    Aesthetic/cosmetic surgery

  • -

    Hand/upper extremity outpatient surgery

  • -

    Lipomas and other outpatient skin/soft tissue benign tumors

  • -

    Migraine surgery
  • -

    Acute traumatic reconstruction: facial fractures, long-bone fractures, and acute soft tissue reconstruction

  • -

    Reconstruction for acutely created cancer defects

  • -

    Aggressive cutaneous cancer resections (melanoma, Merkel cell)
Vascular
  • -

    Severe COPD
  • -

    Elective venous cases interventions for claudication

  • -

    Asymptomatic carotid procedures
  • -

    <6 cm AAA
  • -

    New hemodialysis access creation
  • -

    CLI and ALI procedures

  • >6 cm AAA or TAAA

  • -

    Symptomatic carotid

  • -

    Ruptured or infected procedures (vascular surgery emergencies)

  • -

    Aortic dissections

  • -

    Acute mesenteric ischemia
Cardiac
  • -

    CABG stable CADz

  • -

    TAVR/valve nonurgent

  • -

    TEVAR nonurgent

  • -

    Aneurysm nonurgent

  • -

    VAD

 N/A
  • -

    Acute aortic dissection

  • -

    Transplants

  • -

    Left main coronary artery disease/CABG

  • -

    Post-MI VSD, Mitral
Thoracic
  • -

    Surgical lung biopsy
  • -

    Diaphragmatic plication

  • -

    Decortication for stable trapped lung
  • -

    Lung cancer surgery

  • -

    Esophageal cancer surgery

  • -

    Mediastinal tumor

  • -

    Lung transplant patients awaiting at home or floor

  • -

    Empyema thoracoscopy

 N/A
  • -

    Lung transplant patients admitted to TVICU

  • -

    ECMO cannulation and initiation

  • -

    Thymectomy on patients with unstable myasthenia
Congenital heart surgery
  • -

    Elective heart defects

  • -

    Chronic heart defects with -ASD, sinus venous ASD with PAPVR

  • -

    Elective VSD in older patients
  • -

    Some single ventricular patients

  • -

    Some patients with shunt lesions
  • -

    Single ventricles that are hypoxemic

  • -

    Transplants

  • -

    VADs for sick patients with heart failure

  • -

    Infected endocarditis

  • -

    Kids with acute heart failure

  • -

    Infections requiring urgent surgery
Congenital heart cath
  • -

    Transplant (surveillance cath)

  • -

    Chronic lung disease

  • -

    Trach/vent dependent

  • -

    Other comorbidities involving CV/pulmonary system (mainly ACHD)
  • -

    Elective device closures

  • -

    Noncritical valve interventions and stents

  • -

    Asymptomatic outpatient transcatheter valve implantation
  • -

    Single ventricle cath patients

  • -

    Transplant patients with concern for rejection

  • -

    Symptomatic patients requiring valve intervention/ implantation, stent placement, or device closure
  • -

    Routine diagnostic cath without planned intervention
  • -

    Inpatient requiring urgent diagnostic cath or therapeutic intervention

  • -

    Transplant patients with concerns for acute rejection
Congenital Heart EP
  • -

    Transplant

  • -

    Chronic lung disease

  • -

    Trach/vent dependent

  • -

    Other comorbidities involving CV/pulmonary systems (mainly ACHD)
  • -

    Implantable loop recorder implant

  • -

    Diagnostic EPS only
  • -

    EPS/ablation of SVT

  • -

    Pacemaker or ICD generator replacement

  • -

    Device upgrade +/- extraction (elective)
  • -

    EPS/ablation of VT

  • -

    Pacemaker implant (new)

  • -

    Primary prevention ICD implant
  • -

    Ablation for unstable refractory arrhythmias

  • -

    Infected device extraction

  • -

    Secondary prevention ICD implant (postarrest)
Pediatric surgery
  • -

    Cystic fibrosis

  • -

    Respiratory illness/vent dependent

  • -

    Large burns (immune issues)
  • -

    Stoma reversals

  • -

    Outpatient gastrostomy tubes (with temporary tube in place)

  • -

    Congenital lung lesions

  • -

    Benign masses

  • -

    Outpatient cholecystectomy

  • -

    Interval appendectomy

  • -

    Neck masses (eg, thyroid)

  • -

    Small burns (outpatient)
  • -

    Bowel resections (nonobstructive)

  • -

    Symptomatic gallbladder disease

  • -

    Need for feeding access (especially inpatients to facilitate discharge)

  • -

    Some malignancy-associated procedures (central access, resections)
  • -

    Inguinal hernia repair

  • -

    Orchiopexy

  • -

    Circumcision

  • -

    Umbilical hernia

  • -

    Integumentary surgery (skin lesions, nail lesions, etc)

  • -

    EGD/colonoscopy

  • -

    Breast masses

  • -

    Neck masses (superficial)

  • -

    Awaiting surgery for discharge (hernia, g-tube, etc)
  • -

    All emergent procedures (eg, appendicitis, cholecystitis, trauma, burn debridement, bowel obstructions, GI bleeding)

  • -

    Malignancies requiring biopsy or resection to start therapy

  • -

    Empyema not responding to medical management

  • -

    Newborn surgical procedures

  • -

    ECMO

  • -

    Incarcerated hernia

  • -

    Esophageal/airway foreign bodies

  • -

    Gonadal torsion (testicular, ovarian)
Abdominal transplant surgery
  • -

    Elderly (older than 70 y) – unless need for urgent dialysis access

  • -

    Pancreas transplants
  • -

    Excision of benign mass
  • -

    Excision of some malignant masses

  • -

    Living donor kidney transplants (being delayed until at least April 28, 2020, as of March, 17, 2020; will then be reassessed)
  • -

    Day-stay surgeries

  • -

    Procedures on patients already admitted, allowing for immediate discharge
  • -

    Acute abdomen or surgical equivalent

  • -

    Required surgical intervention for infection

  • -

    Liver transplants MELD over 25 years old or ill

  • -

    Detailed acceptance criteria for deceased donor kidney transplants created based on both recipient and donor graft risk criteria

  • -

    Excision of some malignant masses
Neurosurgery
Vascular
  • -

    Any open surgical or endovascular elective aneurysm, any open surgical or endovascular elective AVM
  • -

    Open surgical elective aneurysm, open surgical elective AVM, open surgical carotid in patient of any age
  • -

    Endovascular elective aneurysm, endovascular elective AVM, endovascular elective carotid in patient of any age
  • -

    Diagnostic cerebral angiograms
  • -

    Ruptured aneurysm, ruptured AVM, acute stroke, ICH
Neurosurgery
Spine
  • -

    Elective degenerative spine surgery without motor deficit, or stable motor deficit >3 mo
  • -

    Resection of benign spinal mass, for example, meningioma, schwannoma without motor deficit or stable motor deficit >3 mo

  • -

    Spinal instability that can be managed indefinitely with a brace

  • -

    Elective spinal procedure requiring multilevel spinal instrumentation (cervical, thoracic, or lumbar)
  • -

    Spinal condition with a stable motor deficit >72 h

  • -

    Any spinal condition that is not emergent but requires inpatient management until definitively treated (eg, unstable thoracic fracture on bed rest until surgery)

  • -

    Malignant primary or secondary spinal tumor

  • -

    Progressive cervical or thoracic myelopathy, spine tumor without deficit but cord compression
  • -

    Level 1 or 2 lumbar decompression

  • -

    Level 1 anterior cervical surgery or level 1–2 posterior cervical decompression

  • -

    Single level ACDF, microdiscectomy, single level laminectomy
  • -

    Spinal cord/ nerve compression or spinal instability with <72 h motor deficit or progressive motor deficit within 72 h

  • -

    Spine fracture, spine pathology with an acute severe neurologic deficit (ie, tumor, abscess/osteo, cauda equina)
Neurosurgery
Stereotactic/radiosurgery/brain tumors, trigeminal neuralgia
  • -

    Benign, minimally symptomatic tumor
  • -

    Benign brain tumors, elective cervical/lumbar stenosis cases

  • -

    Benign minimally symptomatic tumor of any age
  • -

    MVD cases where patients are in a lot of pain, symptomatic benign posterior fossa lesions

  • -

    Benign tumor of any age with moderate neurologic symptoms
  • -

    Outpatient radiosurgery and RFL cases

  • -

    Malignant brain tumor of any age
  • -

    Intracranial bleeding, symptomatic large brain tumors, symptomatic spinal cord lesions, trauma

  • -

    Hospitalized benign brain tumor patient with significant neurologic symptoms or hospitalized malignant brain tumor
Pediatric neurosurgery
  • -

    Respiratory illness/vent dependent
  • -

    Chiari decompression (most)

  • -

    Cranioplasty for skull dehiscence or contour

  • -

    Craniotomy for epilepsy focus, nontumor

  • -

    Vagus nerve stimulator new implant

  • -

    Baclofen pump new implant

  • -

    Dorsal rhizotomy

  • -

    Stereo EEG

  • -

    Scoliosis or other spinal deformity repair (1- to 3-mo delay)
  • -

    Cranioplasty after decompressive craniectomy

  • -

    Craniosynostosis (most)

  • -

    Spinal cord detethering (most)

  • -

    Cranial/spinal tumor biopsies/resections (most)

  • -

    Discectomy/laminectomy without acute neurodeficit

  • -

    Pseudomeningocele repair (most)

  • -

    Moyamoya bypass

  • -

    Baclofen pump replacement
  • -

    Scalp dermoid

  • -

    Cranial spring removal

  • -

    Muscle/nerve biopsy

  • -

    Vagus nerve stimulator battery replacement
  • -

    Shunt placement/revision

  • -

    Spinal instability/trauma

  • -

    Endoscopic hydrocephalus surgery

  • -

    Evacuation of intracranial/intraspinal hematoma or empyema

  • -

    Myelomeningocele closure

  • -

    Congenital encephalocele repair

  • -

    CSF leak repair

  • -

    Discectomy/laminectomy with acute neurodeficit

  • -

    Decompressive craniectomy

  • -

    Repair of open or depressed skull fracture

  • -

    Other urgent or emergent cases as dictated by patient status
Neurosurgery, epilepsy surgery, pituitary tumors
  • -

    Any elective epilepsy or pituitary case in patient aged 70 y or older or with pulmonary disease
  • -

    RNS for epilepsy, transsphenoidal surgery for pituitary tumor, stereo EEG for epilepsy, anterior temporal lobectomy for epilepsy
  • -

    VP shunt for pseudotumor pituitary tumor with visual field defect
  • -

    Sural nerve biopsy

  • -

    VNS placement and VNS generator change
  • -

    Transsphenoidal surgery for pituitary apoplexy
Neurosurgery, DBS Any elective DBS or battery change procedure in patient 70 years or older, immunocompromised, or with respiratory disease Elective DBS surgery in patients <70 years old Battery change procedures in patients <70 years old Infected DBS or infected battery
Otolaryngology
  • -

    Immunocompromised

  • -

    Elderly (older than 70 y)

  • -

    Chronic respiratory disease

  • -

    Cystic fibrosis

  • -

    Elective aerosol-generating procedures, such as endoscopy, bronchoscopy

  • -

    Tracheotomy dependent
  • -

    Most tonsil/adenoid removals

  • -

    Benign thyroid and parotid masses

  • -

    Tympanoplasties and mastoidectomies

  • -

    Cochlear implants

  • -

    Chronic inflammatory endoscopic sinus surgery

  • -

    Septorhinoplasty
  • -

    Malignancy of upper aerodigestive tract or salivary glands

  • -

    CSF leaks

  • -

    Sinonasal tumors

  • -

    Facial trauma

  • -

    Laryngotracheal stenosis, especially if not tracheostomized

  • ∗

    ∗These cases could wait a short duration, but not >3–4 wk

Cases occurred at an ambulatory surgical center
  • -

    Emergent airway

  • -

    Neck abscesses

  • -

    Orbital or intracranial complications of otitis media or sinusitis

  • -

    Invasive fungal sinusitis
Psychiatry, ECT
  • -

    Immunocompromised

  • -

    Elderly (older than 70 y)

  • -

    Respiratory disease

  • -

    Cardiac disease

  • -

    Other comorbidity
  • -

    Maintenance ECT for prevention of relapse
  • -

    Post-ECT taper

  • -

    Nonsuicidal in ECT treatment series

 High acuity in mid-ECT series
  • -

    Catatonia with severe malnourishment

  • -

    Suicidal inpatients in mid-ECT series
Trauma orthopedics -
  • -

    Malunion

  • -

    Some nonunion with intact hardware

  • -

    Posttraumatic fusion/arthroplasty
  • -

    Some fractures
  • -

    Minor hardware removal

  • -

    Manipulation under anesthesia

  • -

    Some fractures
  • -

    Acute fractures

  • -

    Infection

  • -

    Polytrauma
Foot and ankle -
  • -

    Mostly elective

  • -

    Below-knee amputation

  • -

    Most Charcot reconstruction

  • -

    Ankle replacements or similar reconstruction
  • -

    Some elective partial foot amputation

  • -

    Some elective below-knee amputation
  • -

    Mostly elective sports, arthritis, outpatient trauma, reconstructive foot and ankle surgery

  • -

    All digit amputations
  • -

    Acute or acute on chronic infections

  • -

    Polytrauma with foot fracture as main orthopedic injury
Orthopedic, spine
  • -

    Elective degenerative spine surgery without motor deficit, or stable motor deficit >3 mo
  • -

    Resection of benign spinal mass without motor deficit or stable motor deficit >3 mo

  • -

    Spinal instability that can be managed indefinitely with a brace.
  • -

    Spinal condition with a stable motor deficit >72 h

  • -

    Malignant primary or secondary spinal tumor

  • -

    Any spinal condition that is not emergent but requires inpatient management until definitively treated (eg, unstable thoracic fracture)
  • -

    Level 1 or 2 lumbar decompression or microdiscectomy

  • -

    Level 1 anterior cervical surgery

  • -

    Level 1–2 posterior cervical decompression
  • -

    Spinal cord/nerve compression or spinal instability with <72 h motor deficit or progressive motor deficit within 72 h
Orthopedic oncology
  • -

    Benign bone

  • -

    Benign soft tissue

  • -

    Hardware removal

  • -

    Hardware revision
  • -

    Malignant bone

  • -

    Soft tissue
  • -

    Rare

  • -

    Benign soft tissue or bone
  • -

    Acute fractures

  • -

    Infection

  • -

    Pathologic fractures

  • -

    Malignant tumors with window for care (eg, RT, chemotherapy)
Pediatric orthopedics
  • -

    Elective spine deformity

  • -

    Hip/LE surgery for CP, neuromuscular

  • -

    LE osteotomies

  • -

    Clubfoot revisions
  • -

    Some fractures can be delayed 7–10 d
  • -

    Elective LE and foot deformity surgery (ambulatory surgery only)

  • -

    Arthroscopy/peds sports

  • -

    Clubfoot tenotomy
  • -

    SCFE from ED

  • -

    Fracture fixation or casting

  • -

    Septic arthritis/osteomyelitis/abscess

  • -

    Spine trauma requiring fixation
Orthopedic sports med
  • -

    Knee

  • -

    Arthroscopic meniscectomy, debridement, microfracture, plica excision

  • -

    ACL reconstruction

  • -

    Shoulder

  • -

    Arthroscopic debridement, degenerative rotator cuff repair, biceps tenodesis/tenotomy, slap repair, subacromial decompression, distal clavicle excision

  • -

    Hip

  • -

    Arthroscopic hip surgery

  • -

    Elbow

  • -

    Arthroscopic and open elbow surgery (excluding fracture/dislocation)
  • -

    Should be done within 7–14 d:

  • -

    Acute shoulder instability

  • -

    Patella instability with osteochondral fragment

  • -

    Acute displaced/unstable chondral fragment

  • -

    Closed fracture fixation

  • -

    Subacute/chronic periprosthetic joint infection without systemic symptoms (ie, sepsis)

  • -

    Acute rotator cuff tear

  • -

    Surgery that would result in loss of athletic season if not performed

  • Major tendon/ligament tear

  • -

    Pectoralis

  • -

    Biceps

  • -

    Achilles

  • -

    Quad/patella

  • -

    Hamstring

  • -

    Triceps

  • -

    Collateral ligament repair

  • -

    ACL repair
  • -

    Elective LE and foot deformity surgery (ambulatory surgery only)

  • -

    Arthroscopy/peds sports

  • -

    Clubfoot tenotomy
  • -

    Irreducible dislocations/unstable dislocations

  • -

    Native or prosthetic

  • -

    Septic joint

  • -

    Infection

  • -

    Native or surgical site

  • -

    Open fracture

  • -

    ACL with bucket handle meniscal tear

  • -

    Displaced bucket handle meniscal tear

  • -

    Periprosthetic fracture fixation

  • -

    Acute periprosthetic joint infection

  • -

    Subacute/chronic periprosthetic joint infection with systemic symptoms, ie, sepsis

  • -

    Fractures with neurovascular compromise

  • -

    Locked elbow or knee

  • -

    Current matched fresh allografts
Arthroplasty
  • -

    SNF bound
  • -

    Elective inpatient

  • -

    Primary and revision
  • -

    Same as level 2 except for severe limitation, pain, or immobility
  • -

    Outpatient healthy total joint arthroplasty
  • -

    Fractures, acute prosthetic joint infection

  • -

    Dislocations of a joint

  • -

    Other emergent, urgent
Urology
  • -

    Reconstructive surgery for transplant clearance
  • -

    PCNL for asymptomatic stone without tubes

  • -

    Pelvic floor repairs

  • -

    Fistula case

  • -

    Benign urinary diversion

  • -

    Bladder diverticulum

  • -

    Outlet reduction procedure

  • -

    Penile prosthesis

  • -

    AUS

  • -

    Penile plication

  • -

    Hidden penis repair

  • -

    TURP/PVP

  • -

    Excision of benign adrenal tumor

  • -

    Bladder and bowel reconstruction: bladder augment, bladder catheterizable channel, cecal catheterizable channel, ureteral reimplant
  • -

    Excision of malignant mass (prostate, kidney, bladder, testis, and penis)

  • -

    Excision of benign mass affecting health

  • -

    PCNL for symptomatic stones or drainage tubes in place

  • -

    Ureteroscopy for symptomatic stones or drainage tubes in place

  • -

    Pyeloplasty

  • -

    Urethroplasty

  • -

    Ileal ureter

  • -

    Ureterolysis

  • -

    Pediatric benign nephrectomy
  • -

    Inguinal orchiectomy

  • -

    TURBT

  • -

    Ureteroscopy for asymptomatic stone without tubes

  • -

    Ureteral stent change

  • -

    Minor pelvic floor repairs

  • -

    Anti-incontinence procedures

  • -

    Sacral neuromodulation

  • -

    Cysto/RUG/SPT

  • -

    ProAct placement

  • -

    Male sling placement

  • -

    DVIU/urethral dilation

  • -

    Excision/ablation condyloma

  • -

    UroLift

  • -

    Penile abnormality surgery (circumcision, penile adhesion, hypospadias)

  • -

    Inguinal hernia

  • -

    Undescended testis
  • -

    Testicular torsion

  • -

    Urinary tract infections associated with obstruction

  • -

    Acute urinary tract obstruction associated with decline in renal function

  • -

    Priapism

  • -

    Fournier’s gangrene

  • -

    Cystoscopy with clot evacuation

  • -

    Explant infected prosthetic device

  • -

    Pediatric malignancy not testis
Pain medicine
  • -

    Minimally invasive pain procedures, implants, and percutaneous interventions

  • -

    Elderly (older than 75 y)

  • -

    Steroid injections for patients with comorbidities (postpulmonary/cardiac transplant, COPD with O2 dependency, uncontrolled diabetes)

 -Hospitalized patients: percutaneous pain interventions/minimally invasive pain procedures/implants to facility hospital discharge.
  • -

    Outpatient: emergency/complications (eg, infection) of implant
Interventional radiology

Visceral

  • -

    Varicose veins

  • -

    Hydrocele sclerotherapy

  • -

    TIPS revision: ascites

  • -

    Vertebral augmentation

  • -

    Embo: gonadal vein

  • -

    Nerve injections

  • -

    Embo: fibroid

  • -

    IVC filter removal

  • -

    CVL/port removal (completion of therapy)

  • -

    Feeding tube exchange (routine)

Peds

  • -

    VCUGs

  • -

    Renograms

  • -

    Barium GI series for chronic conditions

MSK

  • -

    Imaging-guided soft tissue (trigger point) injection

Neuro/spine

  • -

    Sclerotherapy and Botox injections

Visceral

  • -

    Embo: fibroid

Visceral

  • -

    Transjugular liver biopsy

  • -

    PTHD (low acuity)

  • -

    PCN: new (low acuity)

  • -

    TIPS placement: ascites (possibly >14 d)

  • -

    Percutaneous ablation (possibly >14 d)

  • -

    Embo: pulmonary AVM (possibly >14 d)

  • -

    TIPS revision: bleeding

Body

  • -

    Native kidney biopsy

  • -

    Lung mass biopsy

  • -

    Abdominal mass high-risk biopsy

Neuro/spine

  • -

    Multilevel blood patch

  • -

    Multistaged sclerotherapy

Visceral

  • -

    Embo: gonadal vein, liver – tumor (TAE/TARE)

  • -

    Dialysis procedures

  • -

    Varicose veins

  • -

    Hydrocele sclerotherapy

  • -

    IVC filter placement/removal

  • -

    Cholangiogram

  • -

    Feeding tube placement/change

  • -

    Tunneled ascites catheter

  • -

    Catheter/CVL exchange or removal (any)

  • -

    Port/tunneled CVL placement

  • -

    Vertebral augmentation, nerve injections

  • -

    TIPS revision: ascites

Body

  • -

    Breast mass biopsy

  • -

    Thyroid FNA

  • -

    Lymph node biopsy

  • -

    Paracentesis/thora

  • -

    Seroma/superficial abscess drainage

  • -

    Low-risk abdominal mass or soft tissue biopsy

Neuro/spine

  • -

    LPs/Myelograms

  • -

    FNA/biopsies of head, neck, or spine

  • -

    Sclerotherapy and Botox injections

MSK

  • -

    Arthrocentesis

  • -

    Imaging-guided biopsy

  • -

    Imaging-guided soft tissue (trigger point) injection

Visceral

  • -

    PTHD (high acuity)

  • -

    PCN: new (high acuity)

  • -

    Embo—any hemorrhage

  • -

    Thrombolysis

  • -

    TIPS placement: history of bleeding

Body

  • -

    Abdominal/pelvic abscess drainage

  • -

    Empyema

Peds

  • -

    Intussusception reduction

  • -

    Barium study for malrotation
Ophthalmology
  • -

    Cataracts that impact legal driving standards

  • -

    Conjunctival or corneal neoplasm

  • -

    Pediatric cataracts

  • -

    Advanced TRD in monocular patient
  • -

    Cataracts >12 year old

  • -

    Blepharoplasty

  • -

    Chalazion

  • -

    Ectropion/entropion repair

  • -

    Nasal lacrimal duct probing

  • -

    Macular hole

  • -

    PPV/ERM peel

  • -

    Strabismus >10 year old

  • -

    Mild/moderate glaucoma with >135 degrees of binocular field

  • -

    PTK/Lasik/PRK

  • -

    Routine transplants

  • -

    Pterygium surgery
  • -

    Globe rupture

  • -

    Endophthalmitis

  • -

    Bilateral vitreous hemorrhage

  • -

    Emergency transplant

  • -

    Perforated ulcer

  • -

    Eyelid malignancy excision/repair

  • -

    Vitreous biopsy/FNA of choroidal mass

  • -

    Rhegmatogenous RD

  • -

    Advanced or neovascular glaucoma

  • -

    Hyphema with high IOP

  • -

    ROP

  • -

    Phacomorphic angle closure

  • -

    Intraocular foreign body

  • -

    Intraocular tumor

AAA, abdominal aortic aneurysm; ACDF, anterior cervical discectomy and fusion; ACHD, adult congenital heart disease; ACL, anterior cruciate ligament; AIN, anal intraepithelial neoplasia; ASD, atrial septal defect; AUS, artificial urinary sphincter; AVM, arteriovenous malformation; CABG, coronary artery bypass graft; CAD, coronary artery disease; COPD, chronic obstructive pulmonary disease; COVID-19, 2019 novel coronavirus; CP, cerebral palsy; CSF, cerebral spinal fluid; CV, cardiovascular; CVL, central venous line; DBS, deep brain stimulation; DVIU, direct vision internal urethrotomy; ECMO, extracorporal membrane oxygenation; ECT, electroconvulsive therapy; EEG, electroencephalogram; EGD, esophagogastroduodenoscopy; EP, electrophysiology; EPS, electrophysiology studies; ERM, epiretinal membrane; FNA, fine needle aspiration; GI, gastrointestinal; ICD, implantable cardioverter defibrillator; ICH, intracerebral hemorrhage; ICU, intensive care unit; IOP, intraocular pressure; IVC, inferior vena cava; LE, lower extremity; LP, lumbar puncture; MELD, model for end-stage liver disease; MI, myocardial infarction; MSK, muskuloskeletal; MVD, microvascular decompression; N/A, not applicable; PAPVR, partial anomalous pulmonary venous return; PCN, percutaneous nephrostomy; PCNL, percutaneous nephrolithotomy; PEG, percutaneous endoscopic gastrostomy; PPE, personal protective equipment; PPV, pars plana vitrectomy; PRK, photorefractive keratectomy; PTHD, percutaneous transhepatic biliary drainage; PTK, phototherapeutic keratectomy; PVP, photo-vaporization of prostate; RD, retinal detachment; RNS, responsive neurostimulation for seizures; ROP, retinopathy of prematurity; RT, radiation therapy; SNF, skilled nursing facility; SPT, suprapubic tube; SVT, supraventricular tachycardia; TAAAA, thoracoabdominal aortic aneurysm; TAVR, transcatheter aortic valve replacement; TEVAR, thoracic endovascular aortic repair; TIPS, transjugular intrahepatic portosystemic shunt; TRD, tractional retinal detachment; TURBT, transurethral resection of bladder tumor; TURP, transurethral resection of prostate; TVICU, thoracic/vascular intensive care unit; VAD, ventricular assist device; VCUG, voiding cystourethrogram; VP, ventriculoperitoneal; VSD, ventriculoseptal defect.

Weber LeBrun. COVID-19 pandemic: staged management of surgical services for gynecology and obstetrics. Am J Obstet Gynecol 2020.