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Postoperative adhesions represent a frequent complication of abdominal surgery. Adhesions can result from infection, ischemia, and foreign body reaction, but commonly develop after any surgical procedure. The morbidity caused by adhesions affects quality of life and, therefore, it is paramount to continue to raise awareness and scientific recognition of the burden of adhesions in healthcare and clinical research. This 2021 Global Expert Consensus Group worked together to produce consented statements to guide future clinical research trials and advise regulatory authorities. It is critical to harmonize the expectations of research, to both develop and bring to market improved anti-adhesion therapies, with the ultimate, shared goal of improved patient outcomes.

Study Objective To establish baseline information on the practice of gynecologic endoscopists amid the COVID-19 pandemic Design Online survey was conducted among Fellows of the Philippine Society for Gynecologic Endoscopy (PSGE) from October 3 to October 12, 2020. Setting Nationwide. Patients or Participants Fellows in practice. Interventions Online survey distributed to participants via email. Measurements and Main Results The survey consisted of 5 subsections: (1) demographic data, (2) impact of COVID-19 pandemic on MIGS practice, (3) changes of practice during the COVID-19 pandemic, and (4) changes in the conduct of surgery and post-operative care. A frequency distribution table was used to summarize responses. A total of 119 out of 144 PSGE Fellows participated in the survey. Average age was 53 years old, majority practicing in the National Capital Region, and practicing for more than fifteen years. Nearly all respondents cancelled surgeries due to the pandemic. As of the time of the survey, only 41% and 68.1% of Fellows had returned to perform laparoscopy and hysteroscopy respectively. Most respondents noted that their hospital of practice provided protocols for elective surgery. Majority (71.4%) reported reduced surgical staff with 30.6% due to resignation. Clinical practice saw the shift from face-to-face consults to the use of telemedicine (74.8%). Face masks and shields, and PPE were the top three precautions taken in the clinics, while symptom assessment, temperature screening, and RT-PCR testing were the most common screening procedures prior to surgery. Respondents also preferred laparotomy over laparoscopy (64.7%). Most of the respondents reported availability of disposable equipment, use of face mask, eye protection, and half or full respirator mask in the operating room. Conclusion The findings show that the COVID-19 pandemic markedly disrupted clinical and surgical practice among Fellows across the country. Adaptation of several precautionary measures and screening procedures to reduce the risk of SARS-CoV 2 transmission to patients and healthcare workers were done.

INTRODUCTION: The COVID 19 infection has greatly affected health care delivery in the Philippines. However, the concerns of healthcare workers have yet to be explored Objective: This study determined the logistical concerns of the residents and fellows of an academic government hospital that serves as a COVID-19 referral center in the Philippines. METHODS: This is a cross-sectional, online survey administered to the trainees of the Department of Obstetrics and Gynecology. RESULTS: Eighty-seven participants were included in the study. Mean age was 30.7 ±3.7. Most were single, female and resident doctors. Eighty-one percent agreed there was easy access to food and water during duty and that the food and water provided by the hospital were adequate. Fifty-four percent agreed that they feel safe going to and from the hospital. However, fifty-five percent disagreed to feeling safe from COVID-19 within the hospital. A high majority of the participants agreed that they have access to personal protective equipment but only fifty-eight percent agreed that the supply was adequate. The top 5 logistical concerns identified were: (1) safety and security, (2) food, (3) supply of personal protective equipment, (4) water, and (5) transportation. CONCLUSION: Although provisions on basic needs and protective equipment were adequate, trainees still felt unsafe from COVID-19 within the hospital. Both the government and hospital administrators must continue to work together to improve strategies to address concerns of frontliners.

OBJECTIVE: This study aims to establish baseline information on the practice of minimally invasive gynecologic surgery (MIGS) among Filipino gynecologic endoscopists amid the COVID-19 pandemic. MATERIALS AND METHODS: An online survey was conducted among Fellows of the Philippine Society for Gynecologic Endoscopy (PSGE) practicing in private and government hospitals in the Philippines after informed consent. The survey had five subsections: (1) demographic data, (2) impact of COVID-19 pandemic on MIGS practice, (3) changes of practice during the COVID-19 pandemic, and (4) changes in the conduct of surgery and postoperative care. RESULTS: A total of 119 out of 144 PSGE Fellows based in the Philippines participated in the survey, 83% were Fellows in both laparoscopy and hysteroscopy. The majority had more than 15 years of practice and were practicing in the National Capital Region. Surgeries were canceled initially but have since resumed. The majority were hysteroscopy cases, the most common being polypectomy. Majority of the respondents reduced their clinic hours and appointments. Most have used telemedicine for consultations. Use of face masks, face shields, and personal protective equipment (PPE) were the top precautions taken in the clinics. Screening and precautions per guidelines inside the operating room setting were observed. Modifications during surgery include the use of smoke evacuators, minimizing energy device use, and wearing enhanced PPE. CONCLUSION: The volume of laparoscopy and hysteroscopy cases was greatly reduced during the pandemic. The pandemic has disrupted the practice of MIGS both in the outpatient clinics and the operating rooms. Most of the changes made are congruent to local and international automotive task force guidelines. Precautionary measures and screening procedures must remain in place to reduce the risk of severe acute respiratory syndrome coronavirus 2 transmission to patients and health-care workers.