Critical Appraisal

SANRA
● Three Scoring Options - for swift and pragmatic sum
score

● It is not designed as an exact measurement of the

quality of manuscripts - “Pragmatic Approach”
● Justifications of the article’s importance for
the readership - 2
Clinical Problem: Safety of Laparoscopic
Surgery during the pandemic?
“The safety of laparoscopy during the pandemic was then
debated”

“We focused on the laparoscopic use of Co2, the possible gas

leak, the possible viral contamination from laparoscopy, the
benefits of laparoscopy and other management options such as
conservative and open surgery.”
● Statement of concrete aims or formulation of
questions - 2
What is the aim of the study?

“Systematically review the literature regarding the

safe use of laparoscopy during COVID-19”
● Description of the Literature Search - 2

● PuBMeD
● ScienceDirect
● Gray Citations
● Description of the Literature Search - 2
● Referencing - 2

Referencing Technique
2

2
● Scientific Reasoning - 1
Inclusion Criteria: ( What kind of studies are included )

Inclusion Criteria
● Study Designs: Case Presentation
Systematic and Narrative Reviews
Commentary
Overview Correspondence
Expert Opinion Letter to Editor
Perspectives Peer Reviewed Societies
● Scientific Reasoning - 1
Limitation of the study : ( What kind of studies are not
included)
Limitations of the study
No research hits of cohort and RCTs
● Appropriate presentation of Data - 0

Confidence Intervals were not given in the study

It can be measured using your outcome measures
2

2
1

9/12
Critical Appraisal

CEBM
● Did the study address a clearly focused question?
YES
P Patients who underwent Laparoscopic Surgery
during COVID-19 pandemic

I Laparoscopic Surgery
C None
O Safety
M Systematic Review
 ● Was a comprehensive literature search conducted using relevant
research databases (i.e. ABI/INFORM, Business Source Premier,
PsycINFO, Web of Science, etc.).

YES Methods Section Page e30

● PuBMeD
● ScienceDirect
● Gray Citations
● Is the search systematic and reproducible (e.g. were
searched information sources listed, were search terms
provided)? YES

● ‘‘laparoscopic surgery”
● “COVID-19’’
● ‘‘minimally invasive surgery and COVID-19”
● Has publication bias been prevented as far as
possible (e.g. were attempts made at collecting
unpublished data)? YES

Gray Citations
>1 Reviewers
● Was the methodological quality of each study
assessed using predetermined quality criteria ?
YES

>1 Reviewers

Most Common Form of

analysis in qualitative
research
● Was the methodological quality of each study
assessed using predetermined quality criteria ?
YES
● Are the inclusion and exclusion criteria clearly
defined (e.g. population, outcomes of interest,
study design)? Yes

Inclusion Criteria
● Written in English
● Study Designs:
Case Presentation
Systematic and Narrative Reviews
Commentary
Overview
Correspondence
Expert Opinion
Letter to Editor
Perspectives
Peer Reviewed Societies
● Are the inclusion and exclusion criteria clearly
defined (e.g. population, outcomes of interest,
study design)? Yes

Exclusion Criteria
● Not written in English or full text
● Citations not related to laparoscopy under
COVID19
● Are the key features (population, sample size, study
design, outcome measures, limitations) of the
included studies described? NO
● Population
● Sample size
● Study design
● Outcome measures
● Effect sizes
● Limitations
● Are the key features (population, sample size, study
design, outcome measures, limitations) of the
included studies described? NO

Limitations of the study

No research hits of cohort and RCTs
● Were the results similar from study to study?

NO
● How precise is the estimate of the effect? Were
confidence intervals given? NO

Confidence Intervals were not given in the study

It can be measured using your outcome measures
● Can the result be applied in your organization
(Local setting)? Unclear
There are no specific data available yet for the safety
and use of laparoscopic surgery during COVID-19 and
usage of such devices and procedures is in the discretion
of the surgeon without compromising the safety of the
surgical team.