Journal of Multidisciplinary Healthcare (Nov 2022)
The Multidisciplinary Perioperative Management of Conjoined Twin Separation Surgery During the Pandemic
Abstract
Gezy Giwangkancana,1,2 Dikki Drajat Kusmayadi,3 Fiva Kadi,4 Arie Utariani,2 Zahran Haryawan5 1Department of Anesthesiology and Intensive Care, Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin National Referral Hospital, Bandung, West Java, Indonesia; 2Sub-Specialistic Study of Pediatric Anesthesia Study Faculty of Medicine Universitas Airlangga Surabaya, Surabaya, East Java, Indonesia; 3Department of Pediatric Surgery, Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin National Referral Hospital Bandung, Bandung, West Java, Indonesia; 4Division of Neonatology, Department of Pediatrics, Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin National Referral Hospital Bandung, Bandung, West Java, Indonesia; 5Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, IndonesiaCorrespondence: Gezy Giwangkancana, Tel +628122005952, Email [email protected]: 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
