Table 2.
Minimally invasive HPB surgery during the COVID-19 pandemic
| Liver | |
| MIS liver activity as a priority for referral to hub | 52/76 (68.4%) |
| MIS pancreas activity as a priority for referral to hub | 46/76 (60.5%) |
| Low complexity liver resection: switch MIS/open at hub center | |
| Strongly agree or agree | 30/76 (39.5%) |
| Disagree or strongly disagree | 46/76 (60.5%) |
| Intermediate complexity liver resection: switch MIS/open at hub center | |
| Strongly agree or agree | 40/75 (53.3%) |
| Disagree or strongly disagree | 35/75 (46.7%) |
| High complexity liver resection: switch MIS/open at hub center | |
| Strongly agree or agree | 61/76 (80.3%) |
| Disagree or strongly disagree | 15/76 (19.7%) |
| Pancreas | |
| Left pancreatectomy: switch MIS/open at hub center | |
| Strongly agree | 37/76 (48.7%) |
| Disagree | 39/76 (51.3%) |
| Whipple procedure: switch MIS/open at hub center | |
| Strongly agree | 64/75 (85.3%) |
| Disagree | 11/75 (14.7%) |
| General | |
| Prioritization of patients based on: | |
| Time from entry in the waiting list | 28/81 (34.6%) |
| Local resectability pattern | 39/81 (48.1%) |
| Biological aggressiveness | 60/81 (74.1%) |
| Alternative or bridging (including neoadjuvant chemo) treatments available or not | 50/81 (61.7%) |
| ASA score or Charlson Comorbidity Index | 23/81 (28.4) |
| General performance status | 20/81 (24.7%) |
| Indication to MIS in SARS-CoV2 patients | |
| Unmodified as per the timing and type of surgery required | 7/80 (8.8%) |
| Unmodified as per the timing and type of surgery required just if asymptomatic | 7/80 (8.8%) |
| Delayed in timing until SARS-CoV-2 negativization was proved | 66/80 (82.5%) |
| Technical variations in MIS | |
| No | 19/74 (25.7%) |
| Yes: specific smoke aspirations | 36/74 (48.6%) |
| Yes: specific CO2 insufflations | 11/74 (14.9%) |
| Yes: specific attention to skin incisions appropriate to port dimensions | 23/74 (31.1%) |
| Yes: preference for trocars with balloon fixation | 25/74 (33.8%) |
| Yes: energy devices not used | 2/74 (2.7%) |
| Yes: pneumoperitoneal pressures kept at minimum | 28/74 (37.8%) |
| Yes: pneumoperitoneum aspiration before removal of trocars | 41/74 (55.4%) |
| Yes: minimization of time of Trendelenburg position | 6/74 (8.1%) |
| Fast-track protocol during COVID-19 | |
| Yes, same indications | 58/78 (74.4%) |
| Yes, reduced number of indications | 15/78 (19.2%) |
| No, stopped | 5/78 (6.4%) |