Laparoscopic Transvaginal Hybrid Anterior Resection: a Prospective Data Collection

NCT ID: NCT01043731

Last Updated: 2010-12-10

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

Total Enrollment

45 participants

Study Classification

OBSERVATIONAL

Study Start Date

2008-09-30

Study Completion Date

2010-11-30

Brief Summary

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Transvaginal hybrid procedures are of interest as an available NOTES-Procedure for the clinical routine. Few authors have demonstrated the feasibility and safety of such procedures (e.g. cholecystectomy) in selected patient collectives. In 2008 Lacy at al. published the experience with a transvaginal sigmoidectomy as a first in human report. The aim of this prospective data collection is to evaluate the feasibility and safety of the transvaginal hybrid anterior resection in the clinical routine.

Therefore all patients giving the informed consent to the transvaginal hybrid anterior resection will be included and assessed concerning feasibility to perform the transvaginal approach and complete the operation transvaginally.

Detailed Description

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Conditions

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Sigmoid Diverticulitis (Hinchey I and II) Sigmoid Diverticulosis With Two or More Attacks of Diverticulitis

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Ginven indication for laparoscopic anterior resection

Laparoscopic transvaginal hybrid anterior resection

Intervention Type PROCEDURE

Transvaginal Hybrid Anterior Resection: three 5mm trocars are placed transabdominally (one trans-umbilical, the other two in the lower abdomen). Identification of the inferior mesenteric vein and artery. Clipping of the vein. Then placement of a 12mm trocar through the posterior fornix of the vagina for stapling of the inferior mesenteric artery. After mobilisation of the colon descendens and the splenic flexure stapling of the proximal rectum through the 12mm trocar placed vaginally. Afterwards the colpotomy is performed and the mobilised left hemi-colon is extracted transvaginally. The proximal colonic resection is performed extracorporeally in the conventional fashion with placement of a purse-string suture and insertion of the circular stapling anvil into the proximal end of the bowel. The bowel is then replaced into the abdominal cavity. The colpotomy is then closed. A circular stapler is inserted transanally and the end-to-end anastomosis is performed.

Interventions

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Laparoscopic transvaginal hybrid anterior resection

Transvaginal Hybrid Anterior Resection: three 5mm trocars are placed transabdominally (one trans-umbilical, the other two in the lower abdomen). Identification of the inferior mesenteric vein and artery. Clipping of the vein. Then placement of a 12mm trocar through the posterior fornix of the vagina for stapling of the inferior mesenteric artery. After mobilisation of the colon descendens and the splenic flexure stapling of the proximal rectum through the 12mm trocar placed vaginally. Afterwards the colpotomy is performed and the mobilised left hemi-colon is extracted transvaginally. The proximal colonic resection is performed extracorporeally in the conventional fashion with placement of a purse-string suture and insertion of the circular stapling anvil into the proximal end of the bowel. The bowel is then replaced into the abdominal cavity. The colpotomy is then closed. A circular stapler is inserted transanally and the end-to-end anastomosis is performed.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* given informed consent
* sigmoid diverticulosis (two or more attacks)
* sigmoid diverticulitis (Hinchey I and II)

Exclusion Criteria

* ASA IV
* emergency surgery
* liver-malfunction or coagulation disorders
* acute diverticulitis (Hinchey III and IV)
* malignancy
* acute vaginal infection
* refusal of mandatory preoperative gynecological examination
* pregnancy
* endometriosis
* previous surgery of colon and rectum
* strongly retroflexed uterus
* acute pelvic disorders, infection
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Cantonal Hospital of St. Gallen

OTHER

Sponsor Role lead

Responsible Party

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Kantonal Hospital St. Gallen, Department of Visceral Surgery

Principal Investigators

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Andreas Zerz, MD

Role: PRINCIPAL_INVESTIGATOR

Cantonal Hospital St. Gallen

Locations

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Department of surgery

Sankt Gallen, , Switzerland

Site Status

Countries

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Switzerland

Other Identifiers

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EKSG09/151/2B

Identifier Type: -

Identifier Source: org_study_id