Transluminal Flexible Endoscopic Procedure in Foregut and Urologic Surgery

NCT ID: NCT00484783

Last Updated: 2014-12-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

11 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-08-31

Study Completion Date

2009-01-31

Brief Summary

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NOTES access is safe and feasible in the controlled human setting and comparable to standard-of-care surgical techniques. NOTES exploration of the abdomen provides adequate visualization comparable to laparoscopy.

Detailed Description

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This is a prospective clinical trial to evaluate the feasibility of obtaining peritoneal cavity access from natural orifice translumenal endoscopic surgery (NOTES) during combined laparoscopic-endoscopic foregut surgery. Post-operative course will be compared with a historical chart-review control group of patients undergoing standard laparoscopic foregut and urologic surgery.

The study group will be compiled by open enrollment for male and female adult subjects scheduled for combined laparoscopic-endoscopic surgery of the stomach, abdominal esophagus, prostate, bladder, proximal small intestine or who meet inclusion and exclusion criteria. The historical chart-review control group will be randomly chosen from patients from 2003-2006 having undergone combined laparoscopic-endoscopic surgery of the foregut, prostate, or bladder and as determined by CPT coding.

The purpose of the study is to determine if NOTES access and abdominal exploration is feasible, safe, offers comparable visualization to laparoscopy in a controlled human setting.

Conditions

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Gastric Foreign Body, Nos Disorder of Abdomen (Disorder) Foreign Body in Esophagus Prostatic Diseases Disease of Small Intestine

Keywords

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Laparoscopic Surgical Procedures Endoscopic Surgical Procedures Laparoscopic & endoscopic procedures with a gastrotomy or opening in bladder or urethra

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Prospective

Subjects scheduled to receive procedure

Group Type EXPERIMENTAL

Natural Orifice Transluminal Endoscopic Surgery (NOTES)

Intervention Type PROCEDURE

Patients will have the standard laparoscopic procedure and the NOTES procedure will be added. The surgical procedure will require two operating teams: one led by a laparoscopic surgeon, the other by an endoscopic surgeon. During the usual course of the surgery, the flexible endoscope will be passed through the mouth urethra top gain access to the peritoneal cavity.

Historical

Chart review control group

Group Type OTHER

Natural Orifice Translumenal Endoscopic Surgery (NOTES)

Intervention Type PROCEDURE

chart review of historical data from control group

Interventions

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Natural Orifice Transluminal Endoscopic Surgery (NOTES)

Patients will have the standard laparoscopic procedure and the NOTES procedure will be added. The surgical procedure will require two operating teams: one led by a laparoscopic surgeon, the other by an endoscopic surgeon. During the usual course of the surgery, the flexible endoscope will be passed through the mouth urethra top gain access to the peritoneal cavity.

Intervention Type PROCEDURE

Natural Orifice Translumenal Endoscopic Surgery (NOTES)

chart review of historical data from control group

Intervention Type PROCEDURE

Other Intervention Names

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NOTES Surgery NOTES Surgery

Eligibility Criteria

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Inclusion Criteria

* Patients undergoing an already combined laparoscopic and endoscopic foregut procedure with general anesthesia
* Patients undergoing a prostatectomy or cystectomy with general anesthesia
* All patients will have a planned gastrotomy for exploration, foreign body removal, or removal of tissue, making it a contaminated case or a planned cystotomy or urethrotomy for exploration, foreign body removal or removal of tissue such as prostatectomy or bladder resection.
* No overwhelming medical co-morbidities
* Subject is 18 years of age or older
* Subject is his or her own medical decision maker
* Subject agrees to participate, fully understands content of informed consent form, and signs the informed consent form

Exclusion Criteria

* Patients undergoing a non-palliative procedure in the face of resectable adenocarcinoma of the foregut or genitourinary tract
* Linitis Plastica
* Evidence of Active Bowel Obstruction
* Patients with history of oropharyngeal, esophageal, or gastric adenocarcinoma.
* Esophageal stricture prohibiting passage of an endoscope
* Urethral stricture prohibiting passage of an endoscope
* Emergent Surgery
* At any time during pre-operative or intra-operative periods, evidence of unresectability is demonstrated
* Any intra-operative condition prior to surgical resection that results in abortion of the surgical procedure
* Any contraindication to surgery
* Pregnancy or actively breastfeeding women
* Prisoners or Wards of State
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospitals Cleveland Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Jeffrey Marks, MD

Prinicpal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jeffrey M. Marks, MD

Role: PRINCIPAL_INVESTIGATOR

University Hospitals of Cleveland/ Institute for Surgical Innovation

Locations

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University Hospitals of Cleveland Case Medical Center

Cleveland, Ohio, United States

Site Status

Countries

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United States

Other Identifiers

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08-06-13

Identifier Type: -

Identifier Source: org_study_id