Page 2 - World Journal of Laparoscopic Surgery

Editorial 10.5005/wjols-15-2-v

The first case of monkeypox in WHO South-East Asia Region has been reported from India in a 35-year-old man
who arrived from the Middle East earlier this week. The Region has been on alert for monkeypox. Monkeypox can
spread to anyone—children and adults, healthy or immunocompromised. The primary mode of transmission is
skin-to-skin contact. This contact may include direct contact with monkeypox rash, scabs, or body fluids, including
respiratory secretions from a person with monkeypox.
Initial symptoms of monkeypox include fever, body aches, fatigue, and sometimes enlarged lymph nodes.
The disease can result in rashes that lead to red bumps on the skin that can appear on hands, feet, face, mouth,
or even genitals. These rashes can transform into raised bumps or painful puss-filled red papules.
Policymaking for the continuity of surgical care in epidemiological crises of monkeypox constitutes the
most vital step. Surgical services would not support a cessation of activities, since it would not only have consequences as an increase
in morbidity and mortality, but also for the national economy and the survival of the surgeon. Thankfully as a laparoscopic surgeon,
chances of contamination to a surgeon is very less as interior milieu is maintained and in minimal access surgery, there is no direct
contact of surgeon to patient’s wound.
Therefore, it is important to carry out a rapid and effective preparation in the emergency and surgical services in the recognition of
these patients, being clear about their symptoms, forms of diagnosis and therapy. Therefore, we suggest some important recommendations
from admission to the emergency room, during surgery, hospitalization and hospital discharge, following the recommendations given
by the WHO.

Monkeypox surgical safety recommendations
Basic Knowledge
Health personnel must know the definitions of confirmed or suspected cases according to the guidelines stipulated in each country.
MEDICAL ATTENTION
Outpatient care or in emergency services/ Operating theaters: After surgery and hospitalization:
preoperative: 1. Only necessary personnel. 1. According to national and institutional
1. Complete medical history, looking for 2. Adequate use of personal protection health regulations, the entry of visitors
signs of flu or skin lesions. elements. will be considered.
2. Timely diagnosis in the case of 3. Reduction in surgical times. 2. Decrease in hospital stay.
suspicious patients. 4. Minimally invasive procedures. 3. Hospitalization in single-person rooms
3. If the patient is a confirmed case, it 5. Adequate disinfection of the surgical or adequate classification of patients
should be evaluated together with the environment before and after the with or without a diagnosis of MPX.
surgeon to consider the relevance of procedure. 4. Proper use of personal protection
the procedure. elements.
4. Exclusive office for the care of patients 5. Directions and recommendations for
confirmed with MPX. departures.
5. Proper use of personal protection
elements.
6. In case the patient is not an emergency,
the procedure must be monitored
in-person or virtually.
Our belief is that the monkeypox outbreak should not be a cause for the closure of surgical services, as the health service has been
strengthened increasing hospital capacity, intensive care unit beds, and a higher percentage of qualified health personnel, in addition
to multiple laboratories available at national level with the capacity to perform molecular tests for the timely diagnosis of this disease.

RK Mishra
Editor-in-Chief
Chairman
World Laparoscopy Hospital
Gurugram, Haryana, India

World Journal of Laparoscopic Surgery, Volume 15 Issue 2 (May–August 2022) v