Brigham and womens minimally invasive gynecologic surgery

Analysis of COVID-19 Response and Impact on Gynecologic Surgery at a Large Academic Hospital System

Shabnam Gupta et al. JSLS. 2021 Oct-Dec.

Free PMC article

Abstract

Background and objectives: The COVID-19 pandemic dramatically impacted gynecologic surgery. In March 2020, the American College of Surgeons recommended delay of all nonessential invasive procedures. This study characterizes the number and types of procedures performed during the peak pandemic.

Methods: A retrospective cohort study was performed. All patients undergoing gynecological surgery at a large academic hospital system from March 16, 2019 to July 31, 2019 and from March 16, 2020 to July 31, 2020 were evaluated. Data was stratified by three time periods corresponding to state and hospital policy changes. During period 1, no nonessential procedures were advised. During period 2, urgent procedures resumed. During period 3, full surgical reopening was achieved.

Results: In 2019, 1,545 gynecologic cases were performed compared with 942 cases in 2020 (39.0% decrease). There was a 73.6% decrease in cases over period 1, a 20.1% decrease over period 2, and a 2.9% increase over period 3. Cases performed by gynecologic oncologists in 2020 accounted for 58.1% of all gynecologic cases over period 1, 29.4% of cases over period 2, and 33.3% of cases over period 3. In 2020, hysterectomy was the most commonly performed procedure, while surgery for endometriosis and uterine fibroids had the greatest decrease in volume. Among emergency procedures, more surgery for ectopic pregnancy was performed in 2020 compared with 2019.

Conclusion: Many patients had significant delays in receiving gynecologic surgical care during the peak pandemic period. Further studies are indicated to determine the impact of delayed care on patients' quality of life and disease process.

Keywords: Essential gynecologic surgery; Pandemic response; Women’s health.

© 2021 by SLS, Society of Laparoscopic & Robotic Surgeons.

Conflict of interest statement

Conflict of interest: JIE is a consultant for Olympus, Hologic, and Arthrex. All other authors report no conflicts of interest.

Figures

Gynecologic surgery case volume by time period.

Cesarean sections performed by labor and delivery by time period.

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