Most elective surgeries cancelled due to coronavirus crisis – is yours on the list?

All elective surgery other than the most urgent procedures will be put on hold to free up capacity in hospitals dealing with coronavirus, Scott Morrison announced on Wednesday. 

Most category two semi-urgent surgeries and all category three procedures, those set to be performed sometime this year, will be suspended indefinitely.

Only category one surgeries are clear to go ahead, state and federal leaders have agreed after urgent pleas from medical professionals.

On Thursday morning, the Prime Minister announced that the National Cabinet had endorsed the recommendation for states and territories to suspend all non-urgent elective surgery and agreed to extend the deadline for the suspension of semi urgent Category 2 and 3 elective surgeries at private hospitals to 11:59pm on April 1.

The government has cancelled some category two and all category three surgical procedures. Source: AAP

Mr Morrison said on Wednesday the move was needed to free up resources for healthcare staff.

“All elective surgery other than category one and urgent – I stress very urgent category two cases - will be suspended,” he said.

“Elective surgery will allow the preservation of resources, including personal protective equipment, and allow health services to prepare for their role in the COVID-19 outbreak.

“This has already largely been implemented for category one and category two and what this means is a further scaling back of those elective surgeries in category two.”

The decision was quickly welcomed by the Australian Society of Anaesthetists.

"The only way Australian hospitals can effectively prepare for an influx of patients is if we have the time to devote resources to this preparation," president Suzi Nou said.

The decision was quickly welcomed by the Australian Society of Anaesthetists. Source: AAP

"We believe that the health system is not yet ready to cope with the likely massive demand for our services."

But Dr Nou said this was just the start and further action with containment measures would be needed.

In joint statement from the medical colleges, Royal Australian and New Zealand College of Obstetricians and Gynaecologists President, Dr Vijay Roach said “critical gynaecological procedures, including abortion, and all care during birth, including caesarean sections, should continue as usual.”

Urgent, preserving eye surgeries will also be performed, Royal Australian and New Zealand College of Ophthalmologists president Associate Professor Heather Mack emphasised.

All surgical groups will consult and identify critical procedures that can’t be postponed.

Patients with cardiovascular problems are typically classified as category one. Source: AAP

Category one - to go ahead during coronavirus crisis

Dr John Quinn with the Royal Australasian College of Surgeons told Yahoo News Australia category one procedures typically include cancer patients, cardiovascular cases and other patients with progressive symptoms that might risk their life.

Category two - most to be suspended during COVID-19 crisis

Category two surgeries are typically patients with gall bladder disease, other bowel conditions that are not cancer and some patients with orthopaedic problems, Dr Quinn said.

Category three - to be cancelled during coronavirus pandemic

People with varicose veins, non malignant skin conditions or joint replacements would fall into this category, Dr Quinn said.

“Those that don’t need surgeries to be done urgently - they’re not a threat to their life or limb,” he said.

The removal of cancerous skin cells is deemed a category one. Source: AAP

Break down of elective surgeries cancelled due to coronavirus

According to NSW Health, these are the categories of urgency when applied to surgeries.

Category one

  • Amputation of limb

  • Aortic bifurcation graft

  • Biopsy of muscle or breast (could also be classified category two)

  • Bronchoscopy

  • Cardiac catheterisation

  • Cholecystectomy - the removal of a gall bladder (could also be classified category two)

  • Colectomy/Large bowel resection (could also be classified category two)

  • Coronary angioplasty - to widen obstructed arteries/veins

  • Coronary artery bypass graft - vein from leg is moved to restore heart blood flow

  • Cystectomy - bladder removal (could also be classified category two)

  • Endarterectomy - removal of part of the inner lining of an artery

  • Endoscopy - (could also be classified category two)

  • Excision of basal cell carcinoma skin cancer or breast lumps (could also be classified category two)

Bowel resection operations are also category one. Source: Getty
  • Excision of melanoma 

  • Excision of squamous cell carcinoma

  • Femoropopliteal bypass graft - a graft placed around narrowed arteries in upper leg (could also be classified category two)

  • Gastroscopy - test to look inside oesophagus and stomach

  • Heart valve replacement

  • Insertion of hepatic artery catheter

  • Insertion of ureteric stent

  • Laryngectomy

  • Lymph node excision

  • Mastectomy

  • Nephrectomy (could also be classified category two)

  • Pleurodesis

  • Prostatic biopsy

  • Pulmonary artery shunt

  • Radical neck dissection

  • Removal of skin lesions

  • Removal of stone from urinary tract

  • Repair atrial-septal defect

  • Repair patent ductus arteriosis

  • Repair ventricular-septal defect

  • Resection of abdo-aortic aneurysm (could also be classified category two)

  • Retrograde pyelogram (could also be classified category two)

  • Tracheostomy (could also be classified category two)

Craniotomies have been listed by NSW Health as a category two. Source: Getty

Category two

  • Amputation of digit 

  • Biopsy/conization of cervix

  • Bladder neck incision

  • Colposcopy

  • Correction of uretero-pelvic junction

  • Craniectomy

  • Craniotomy

  • Dilatation and curettage

  • Dilation of oesophagus

  • Dilation of urethra

  • Drainage of sub-dural haematoma

  • Endoscopy - small intestine

  • Examination of eye under anaesthesia

  • Excision lesion of pharynx

  • Excision of anal fissure (could also be classified category three)

  • Gastrectomy

  • Hysteroscopy

  • Insertion of ventricular shunt

Gastrectomy surgeries are classified as category two. Source: Getty
  • Laparotomy

  • Lithotripsy

  • Liver biopsy (could also be classified category three)

  • Lobectomy any organ/lung

  • Mandibulectomy/hemi- mandibulectomy

  • Mastoidectomy

  • Microlaryngoscopy

  • Nasendoscopy

  • Orchidectomy (could also be classified category three)

  • Orchidopexy

  • Parotidectomy/Submandibular gland - excision

  • Pilonidal sinus (could also be classified category three)

  • Prostatectomy

  • Pyeloplasty

  • Reimplantation of ureters

  • Release of clubfoot

  • Sphincterotomy

  • Sub-mucosal resection/Nasal

  • Tenotomy of hip

  • Thyroidectomy/hemi-thyroidectomy (could also be classified category three)

  • Trabeculectomy

  • Tracheostomy (could also be category one)

  • Trial of voiding

  • Vitrectomy (including buckling/cryotherapy)

Cochlear implants are a category three surgery. Source: Getty

Category three

  • Acromioplasty

  • Adenoidectomy

  • Appendicectomy (non-emergency)

  • Arthrodesis

  • Arthroscopy

  • Blepharoplasty

  • Bursa – excision

  • Cataract extraction 

  • Change of muscle or tendon length

  • Circumcision (clinical conditions only)

  • Cochlear implant

  • Corneal graft

  • Correction of bat ears

  • Correction of cleft lip/palate

  • Correction of ectropian

  • Cystoscopy

  • Dacrocystorhinostomy

  • Diagnostic laparoscopy

  • Diathermy of warts

  • Diskectomy

  • Drainage of Bartholin's cyst

  • Endometrial ablation

  • Ethmoidectomy

A hysterectomy is a category three in priority. Source: Getty
  • Excision of chalazion, lipoma, ganglion, melanoma, ovarian cyst and pterygium.

  • Female sterilisation

  • Femoral herniorrhaphy

  • Foreign body – removal (non- emergency)

  • Freeing abdominal adhesions

  • Functional Endoscopic sinus surgery (FESS)

  • Fundoplication

  • Gastroscopy (other)

  • Haemorrhoidectomy/Banding of Haemorrhoids

  • Hammertoe – correction/repair

  • Hernia – epigastric, repair

  • Hypospadias repair

  • Hysterectomy

  • Inguinal herniorrhaphy

  • Insertion of Levovorgestrel intra uterine system

  • Insertion P.E, tubes (grommets)

  • Insufflation of fallopian tube (Rubin's test)

  • Joint replacement eg. shoulder (other than hip & knee)

  • Laminectomy/Other Spinal Surgery (excluding diskectomy)

  • Manipulation under Anaesthetic

  • Meatoplasty (urinary)

  • Menisectomy (knee)

  • Myomectomy

  • Myringoplasty/Tympanoplasty

  • Myringotomy

  • Nasal cautery

  • Nasal polypectomy

  • Nerve decompression/release

  • Osteotomy – ankle/foot/arm/facial

  • Osteotomy – hip/femur/tibia/shoulder

  • Pharyngoplasty

  • Probing of naso/lacrimal duct

  • Ptosis – repair, correction

  • Pylorotomy

  • Reconstruction of shoulder, fractured orbit and fractured zygoma

  • Release of carpal tunnel, tongue tie, breast implants, bunion, epididymal cyst, ingrown toenail, pins and plates and skin lesions.

  • Repair incisional hernia, cystocele, rectocele, Dupuytren's contracture/faciectomy/Palmar

  • Fasciectomy, exostosis, hiatus hernia, hydrocele, knee cartilage

  • Repair of knee ligament/ACL reconstruction, rotator cuff, squint and umbilical hernia.

  • Rhinoplasty

  • Salpingo-opherectomy/Oopherectomy

  • Septoplasty

  • Spinal fusion

  • Stapedectomy

  • Tendon release

  • Tonsillectomy

  • Total hip or knee replacement

  • Repair trigger finger/thumb

  • Varicose veins stripping

  • Vasectomy

with AAP

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