The Multidisciplinary Perioperative Management of Conjoined Twin Separation Surgery During the Pandemic

Background: Conjoined twin management, especially separation surgery, is a complex procedure which requires multidisciplinary work in the perioperative period. This complexity further increased with the COVID-19 pandemic, where social distancing protocols and the general reduction in non-COVID-19-re...

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Bibliographic Details
Published in:Journal of multidisciplinary healthcare 2022-01, Vol.15, p.2669-2678
Main Authors: Giwangkancana, Gezy, Kusmayadi, Dikki Drajat, Kadi, Fiva, Utariani, Arie, Haryawan, Zahran
Format: Article
Language:English
Subjects:
Conjoined twins
coronavirus
Coronaviruses
COVID-19
Elective surgery
emergency
Epidemics
Health care industry
Indonesia
Information technology
Leadership
Magnetic resonance imaging
management
Medical personnel
Medical prognosis
Medical referrals
operating room
Original Research
pandemic
Pandemics
Pediatrics
Review boards
Social workers
Surgeons
Surgery
Task forces
Teaching hospitals
Telemedicine
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Summary:Background: Conjoined twin management, especially separation surgery, is a complex procedure which requires multidisciplinary work in the perioperative period. This complexity further increased with the COVID-19 pandemic, where social distancing protocols and the general reduction in non-COVID-19-related health-care services added a new dimension to the modern form of teamwork. Methods: This study focused on the process of preparation for conjoined twin separation surgery during the pandemic from March 2020 to May 2022 with pre-pandemic era comparison. We described the decision-making process and the available facilities in terms of equipment, human resources, and the inclusion of information and technology. Results: Among the essential requirements for separation surgery are doctors from various disciplines, pediatric anesthesiologists, nurses from different specialties, radiologists, rehabilitation specialists, nutritionists, pharmacists, psychologists, social workers, public relations, and information and technology staff. The team composition may change depending on the patient's clinical characteristics and social needs. Surgery preparation consists of a prognostication period, preoperative management, surgery, and discharge. Conclusion: Complex surgery such as conjoined twin separation can be managed effectively by a team of multidisciplinary experts. The application of information technology, to manage changes in multidisciplinary work pre- and post-pandemic, can reduce pandemic-related social restrictions while maintaining effectiveness and increasing efficiency. Keywords: coronavirus, COVID-19, emergency, management, operating room, pandemic, surgery
ISSN:1178-2390
1178-2390
DOI:10.2147/JMDH.S390419