We thank Dr. Costanzi and colleagues for their appreciation and interesting insights about our work.1
We perfectly agree with them that coronavirus disease 2019 pandemic dramatically changed the health system organization and surgeons' duties.
We would like anyway to make some points clear:
We strongly believe that surgeons used to deal with critical patients and committed in the care of acute patients played a key role in facing this pandemic event, which seems to be a mass casualty event. The attitude of surgeons in managing scenarios involving people with different injuries and their ability to prioritize treatment and resources are crucial and effective in the field and in planning the correct hospital strategy. Previous experiences and training in these fields were of paramount importance and deserve attention for the future plans.
Surgical critical care knowledge, one of the pillars of acute care surgery, revealed once more a mandatory background for surgeons.2
The surgeons' role is important in the “hub” hospitals and much more important in the “spoke” hospitals. In our opinion, their help is fundamental in the crisis unit too, of course together with hospital manager and directors, medical and emergency department, logistic, supply, and strategic staff.
We continue, during this pandemic event, to face different surgical scenarios, emergent, urgent, and elective (particularly cancer related), and we continue to use laparoscopy (in coronavirus disease patients too) when the laparoscopic technique is recommended and widely recognized.3–5
We fully agree in using adequate personal protective equipment and the precautions advised.
Regarding patient positioning in severe acute respiratory syndrome coronavirus 2 patients, we never experienced any problem due to Trendelenburg position when required.
Hayato Kurihara, MD
Humanitas Clinical and Research Center
IRCCS
Emergency Surgery and Trauma Unit
Department of Surgery
Rozzano
Milan, Italy
Pietro Bisagni, MD
General Thoracic and Emergency Surgery
Division
Surgical Department
Maggiore Hospital of Lodi
ASST Lodi
Lodi, Italy
Roberto Faccincani, MD
Emergency Department
IRCCS San Raffaele Scientific Institute
Milan, Italy
Mauro Zago, MD
General Emergency Surgery Division
Robotic and Emergency Surgery Department
A. Manzoni Hospital
ASST Lecco
Lecco, Italy
DISCLOSURE
The authors declare no conflicts of interest.
REFERENCES
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