Table 3.

Tips and tricks to perform a safe surgical procedure in COVID-19 era

Performing a safe laparoscopic approach	Performing a safe laparotomy
Check if a closed suction system is available	Avoid huge incision causing loss of biological fluids and staff contamination
Create suitable surgical incisions for the introduction of leak-free trocars such balloon trocars if available	Think to protect the incision with a double ring wound protector, if it is available in according to recommendations for SSI control
Be sure not to contribute in increasing the OR air contamination by creating a leak in the presence of smoke obstructing the intervention	The power settings of electrocautery should be as low as possible
Aspirate the entire pneumoperitoneum before making an auxiliary incision to extract the specimen, at the end of the procedure before removing the trocars or before converting the intervention to laparotomy	Avoid long dissecting times on the same spot by electrocautery or ultrasonic scalpels to reduce the surgical smoke
Keep intraoperative pneumoperitoneum pressure and CO2 ventilation at the lowest possible levels without compromising the surgical field exposure	Use the suction devices to remove the surgical smoke
Reduce the Trendelenburg position time as much as possible. This minimizes the effect of pneumoperitoneum on lung function and circulation, in an effort to reduce pathogen susceptibility	Special attention is warranted to avoid sharp injury or damage of protective equipment, in particular gloves and body protection
Avoid long dissecting times on the same spot by electrocautery or ultrasonic scalpels to reduce the surgical smoke	Minimize the use of drainage