Elective Surgeries Resume: What Surgeries Will Now Look Like

Dr. Michael McHale said the last several weeks have focused on those surgeries tied to cardiovascular disease, neurological disease, and cancer. He says the time now is to focus on surgeries that can no longer wait

NBCUniversal, Inc.

Governor Gavin Newsom gave the all-clear for hospitals to resume essential elective surgeries, but what does this mean for surgeons?

According to some surgeons, they’re a lot more susceptible to catching the coronavirus and are placing additional measures to keep them and their patients safe.

Dr. Michael McHale serves as the surgical director of perioperative services at UC San Diego Health. He’s a gynecologic oncologist and has been ready to resume the next tier of necessary surgeries.

McHale says the last several weeks have focused on those surgeries tied to cardiovascular disease and cancer. And now is the time to focus on those that are time-sensitive and can no longer wait.

“Time-sensitive surgery is for those patients that it was okay to delay their surgery for four, five, six weeks, but that’s no longer okay,” McHale said.

McHale said this might apply to a patient who’s been waiting for that knee or hip replacement. They aren’t able to revert to managing the same volume of surgeries due to the constraints of COVID-19. However, it’s a fluid formula they are continuing to configure.

“The struggle has been making tough decisions and telling patients I have to delay your surgery for four weeks or until the community pressures from the virus have declined," McHale said. "And that’s a challenging conversation to have with patients.”

And the type of surgery they can now take on isn’t the only change. McHale also told NBC 7 that patients requiring surgery are now required to take a COVID-19 test within 24 to 72 hours of surgery.

But hospitals aren’t the only ones needing to rethink the protocols in place when it comes to surgeries.

Oral surgeons, whose work is spent inside people’s mouths, are also at a high level of susceptibility.

County Health leaders told NBC 7 it's up to hospitals and health care providers to ultimately decide their timeline of when to reopen. But if you’re a surgeon whose work is spent inside people’s mouths, extra caution is demanded.

Dr. Peter Nordland is a periodontal plastic surgeon and realizes the dangers he takes on being that close to someone’s mouth. He says he hasn’t been given a rule book on how to deal with COVID-19.

Dr. Robert Gramins is an oral maxillofacial surgeon. He says the very tools he uses puts him at risk. He says patients are now vetted to determine if they might have COVID-19, and he’s increasing the amount of PPE he’s typically used to wearing.

“For oral surgery and dentistry per se, it’s the act of working in someone’s mouth, which is where the virus lives,” Gramins.

Our number one concern is the airborne or aerosolization of the virus,” Gramins said. “Some of the procedures we do  involve using a handpiece, which creates a plume of debris in the air, and that’s why we needed the specific masks and everything else to protest ourselves.”

The doctors also expressed concern about getting patients to come in post-COVID-19. They say calming people’s fears post COVID-19 will be another battle they’ll have to conquer.  

Contact Us