Table 1.

Guidance for surgical management during the Covid-19 pandemic.

Emergency surgery	Test all for Covid-19. Treat all as positive. CT thorax 24 h preoperatively where possible. Add CT thorax if having CT abdomen.
Elective surgery	Risk assessment for Covid-19.
	Greater risks of surgery.
	Consent for greater unknown risk.
	Risk reducing strategies eg stoma.
PPE	PPE for all laparotomies.
	Unless Covid-19 negative (beware of false negatives).
	Wear eye protection.
	Practice donning and doffing.
Theatre	Minimum staffing levels.
	All staff wearing full PPE.
	Stop positive pressure ventilation.
	Smoke extraction.
	Intubation/extubation in theatre.
Laparoscopic	Avoid if possible.
	Filters etc difficult to implement.
	Treat appendicitis and cholecystitis with conservative management/open surgery.
Endoscopy	Emergency only.
	Follow BSG guidance.
	Upper GI endoscopy requires full PPE.