The key changes may be summarised as follows:
- Provision and protection of “cold” sites to deliver elective surgery safely is an absolute priority.
- Surgery for advanced pelvic cancer and multivisceral resection is now included in priority category 3 provided resources are available.
- Preparation of elective patients with 14-days self-isolation, screening questions and swab testing.
- CT chest is no longer recommended as a screening test for COVID-19 prior to elective surgery.
- Anastomosis, where appropriate, does not need to be avoided as there are now sufficient resources for salvage in the event of anastomotic leak.
- Laparoscopic approaches may be used in screened and self-isolated elective patients provided safe practice techniques are observed.
- PPE should still be worn for laparoscopic and open procedures.
- Dual consultant operating is no longer recommended for all cases but should still be used when in the patient’s benefit.
- Operative training, especially of senior trainees, should recommence where feasible.