Closed circuit system in laparoscopy: SARS-CoV-2 pandemic


  • Shrenik Govindaraj St. John’s National Academy of Health Sciences, Bengaluru, Karnataka
  • Sridar Govindaraj Department of General Surgery, Division of Surgical Gastroenterology and Laparoscopy, St. John’s National Academy of Health Sciences, Bengaluru, Karnataka



SARS-CoV-2, Laparoscopy, CCS, Pneumoperitoneum, Energy device, COVID-19


Background: There is a big concern regarding transmission of Severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) during laparoscopy and using energy devices through the carbon dioxide (CO2) pneumoperitoneum. So, we decided to use a novel indigenous innovative closed-circuit system (CCS) to avoid this contamination in operation theatre.

Methods: We set out to do a prospective study in the safety of this innovative closed-circuit system in elective surgeries over 3 consecutive months of May to July 2020, during the peak of SARS-CoV-2 pandemic in a tertiary teaching hospital. We recruited 52 patients undergoing elective laparoscopic surgery in a single laparoscopy unit. The Coronavirus disease 2019 (COVID-19) status was unknown, so we presumed all patients to be potential carriers of SARS-CoV-2. However, we followed the Indian council for medical research (ICMR) and Government of Karnataka (GOK) guidelines of clinical screening before surgery. We observed the postoperative outcome regarding COVID-19 symptoms in Health care workers (HCW) involved in the operation theatre. If required, we do a real time reverse transcription polymerase chain reaction (RT-PCR) to find the true positives.

Results: Of the total 52 (basic and advanced) laparoscopic surgeries performed during this period, only 2 (3.84%) patients turned positive in the postoperative period. They developed COVID-19 symptoms and were tested positive by RT-PCR. None (100%) of the HCW developed any symptoms of COVID-19.

Conclusion: Closed circuit system is a safe and promising technique during laparoscopy.

Author Biographies

Shrenik Govindaraj, St. John’s National Academy of Health Sciences, Bengaluru, Karnataka

Department of General Surgery

Division of Surgical Gastroenterology and Laparoscopy

1st Year Medical Student (MBBS)

Sridar Govindaraj, Department of General Surgery, Division of Surgical Gastroenterology and Laparoscopy, St. John’s National Academy of Health Sciences, Bengaluru, Karnataka

Department of General Surgery

Division of Surgical Gastroenterology and Laparoscopy

Professor and Division Head


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Original Research Articles