Performing surgery in PPE is like walking in spaceship suit, say PGI doctors

Naina Mishra

Tribune News Service

Chandigarh, June 6

The doctors at the Post Graduate Institute of Medical Education and Research (PGIMER) are confronted with a new challenge of performing surgeries on COVID-19 suspected and positive patients while donning Personal Protective Equipment (PPE).

From PPE to protocols, the working of hospitals might never be the same keeping in view the current situation of the COVID-19 pandemic. Even after cases may slow down or cease to exist, medical practice as we know might change, feel medical experts of the PGIMER.

The first of its kind surgery was neurosurgery of a COVID-19 patient with a head injury at NHE (COVID hospital), performed on May 29 in an operation theatre specially created for such patients.

“Once you open the brain, you are completely concentrating on it, regardless of how your outer environment is,” says Dr Anurodh Kumar, who was among the team of doctors conducting neurosurgery of a positive COVID-19 patient.

“But we don’t want to rush the surgeries and break the chain of protocols,” adds Dr Parth Jani of the PGIMER.  

Dr Jani said: “We have to be more cautious about my surroundings so that there is no contamination such as blood spill-over even while carrying out surgeries. The newly designed OT is hotter than the usual as there we wear a triple layer PPE.”

He added: “We have faced difficulties while concentrating as our judgment of how we look at the open brain at the time of performing neurosurgery gets affected. We are mostly sweating in PPEs and get exhausted easily. In normal OTs, we can easily work for six hours. However, there are many barriers and we have to see through those barriers in the triple-layer suit.”

In the PGIMER’s orthopaedic department, the numbers of surgeries have been restricted and the emphasis is on the non-operative treatment.

Dr Karthik from the Department of Orthopaedic said: “There is literature as per which surgeries can increase the mortality rate of patients with coronavirus disease. We are operating only those patients who require it urgently.”

Professor SK Gupta, Head, Department of Neurosurgery, PGIMER, said: “Performing surgery while putting a PPE on is just like wearing a spaceship suit and doing your daily chores. We have to use the same equipment with a variation as the movements get little restricted in PPEs. Nobody has ever experienced this before and thus three to four mock drills were also being conducted to prepare ourselves for surgeries.”

He said: “Timing is critical in surgeries like neurosurgeries irrespective to whether the patient has been tested for COVID-19 or not. Our team of doctors did not wait when the first surgery was to be performed on COVID-19 suspect.”

Gupta added: “COVID-19 is going to continue for an indefinite period. The only way is to test rampantly in order to be sure whether the patient we are treating is COVID positive or not. For that, we are taking the help of a genexpert machine that delivers test in one hour. This will ease us from the mental and physical pressure of operating a COVID-19 patient.”

“Pandemic or no pandemic, we will have to get used to it and all our residents have been trained in donning and doffing,” he said.

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