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Surgery: The road back

Dr. Cabrales

Six weeks after making the mid-March decision to cancel all elective surgeries to help protect our community from the spread of COVID-19, Community Hospital of the Monterey Peninsula (part of Montage Health) reopened its Outpatient Surgery Center on May 1. Since then, as of Monday, May 18, Community Hospital resumed selected scheduled procedures in the main operating room, cath lab/electrophysiology lab, and interventional radiology.

We talked with Community Hospital/Montage Health Vice President of Medical Affairs, Dr. Steven Cabrales about that journey.

1. When Community Hospital started performing surgeries again in the Outpatient Surgery Center, how did it go?

It went really well. We prepared for a small opening, so we started at around 75-percent capacity. The most important thing we did was testing patients for COVID-19 three days before their surgical procedures. We said to them: ‘We’re testing you today, and now we need you to go home and quarantine until your operation’. The offer of testing our patients was the key factor for many of them in deciding to go ahead and have the surgery. There was that level of safety that was very reassuring.

2. What kind of surgeries did you perform initially?

General surgeries such as hernias and gall bladders, endoscopies, orthopedic procedures such as scoping a knee, and gynecological surgeries.

3. Now that you’re up and running in a more broad way with regard to surgeries, how many patients who postponed surgeries have rescheduled?

At least 80 percent have rescheduled. Of those who haven’t rescheduled, very few have said they don’t feel comfortable coming in to the hospital. Again, the offer to test them made them feel safe. And we haven’t had any COVID-19 cases in our hospital for 3 weeks now. That’s another source of comfort. The most common reason for people not rescheduling has been financial.

4. What’s ahead?

We will be looking to increase our surgery volumes. We are considering potentially having surgeries on weekends and/or during extended hours, but there is still a finite group of staff we need to consider. We will be testing more patients in the cath lab, electrophysiology lab, and interventional radiology.

Ultimately, we are also working on a way to ensure that every patient coming into the hospital will be tested for COVID-19. We don’t have enough rapid tests yet, but we think that’s could happen within about a month or so. That way, every patient in the hospital would know their COVID-19 status.

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