Natural Orifice Transgastric Endoscopic Surgical Removal of the Gallbladder (NOTESchole)
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Purpose
Hypothesis: Natural orifice transgastric cholecystectomy with laparoscopic assist will be feasible and have comparable complication rates as standard lap cholecystectomy. Patient benefits will include less pain and scaring.
| Condition | Intervention | Phase |
|---|---|---|
|
Cholecystitis |
Procedure: NOTES assisted laparoscopic cholecystectomy |
Phase 1 Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Clinical Outcomes Trial of Laparoscopic Assisted Transgastric Endoscopic Cholecystectomy |
- Postoperative pain [ Time Frame: 30 days ] [ Designated as safety issue: No ]perceived pain levels and type and frequency of pain medications will be recorded in the patient's medical record.
- Quality of Life [ Time Frame: 30 days post operatively ] [ Designated as safety issue: No ]standardized Quality of Life (QOL) assessment (i.e., SF-36) form filled out by the patient.
| Estimated Enrollment: | 25 |
| Study Start Date: | May 2007 |
| Estimated Study Completion Date: | October 2012 |
| Estimated Primary Completion Date: | October 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: NOTES cholecystectomy |
Procedure: NOTES assisted laparoscopic cholecystectomy
Surgical removal of the gallbladder using endoscopic instruments.
Other Name: NOTES Cholecystectomy
|
Detailed Description:
In this study, we propose to use a surgical technique that eliminates the need for a 1.5-2.5 cm umbilical incision. A flexible endoscope will be inserted through the mouth and into the stomach. Using commercially available endoscopes, endoscopic instruments and accessories, a small incision will be made in the gastric wall and the endoscope will be advanced into the insufflated peritoneal cavity. Two to three small laparoscopic trocars will be placed for laparoscopic instrument insertion to manipulate, retract and cut tissue. The flexible endoscope will provide visualization of the surgical field and flexible endoscopic instruments may be used to augment surgical manipulation with the laparoscopic instruments. Once dissected free, the gall bladder will be removed through the stomach and out of the mouth. Commercially available endoscopic clips, sutures and/or tissue anchors will be used to close the gastrotomy; additionally, the gastrotomy will be tested for leaks and laparoscopically oversewn with suture as needed.
Patients will be discharged per the standard of practice for a laparoscopic cholecystectomy. During the hospital stay severity of pain and use of pain medications will be recorded. Length of time spent in the recovery room and in the hospital will also be collected. Patients will return and be evaluated by their surgeon two weeks following their procedure. At this visit, any complications will be noted in the patient's medical record. Additionally at this visit and at the preoperative visit, patients will complete a standardized Quality of Life (QOL) assessment (i.e., SF-36) and perceived pain levels and type and frequency of pain medications will be recorded in the patient's medical record.
Eligibility| Ages Eligible for Study: | 18 Years to 80 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Ability to undergo general anesthesia
- Age > 18 years of age and < 80 years of age
- Ability to give informed consent
Exclusion Criteria:
- Acute cholecystitis
- Body Mass Index (BMI) > 40
- Contraindicated for esophagogastroduodenoscopy (EGD)
- Gallstones > 2.5cm in diameter
- Gall bladder more than 15cm in length on U/S
- Presence of common duct stones
- Presence of esophageal stricture
- Altered gastric anatomy
Contacts and Locations| Contact: Lee L Swanstrom, MD | 503-281-0561 | lswanstrom@orclinic.com |
| United States, Oregon | |
| Legacy health System | Recruiting |
| Portland, Oregon, United States, 97210 | |
| Principal Investigator: Lee L Swanstrom, MD | |
| Principal Investigator: | Lee L Swanstrom, MD | Legacy Health System |
| Study Director: | Angi B Gill, RN | Oregon Clinic |
More Information
No publications provided
| Responsible Party: | Lee Swanstrom, MD, The Oregon Clinic |
| ClinicalTrials.gov Identifier: | NCT01174069 History of Changes |
| Other Study ID Numbers: | LHS0701 |
| Study First Received: | July 30, 2010 |
| Last Updated: | October 3, 2012 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by The Oregon Clinic:
|
NOTES cholecystectomy endoscopic |
Additional relevant MeSH terms:
|
Cholecystitis Acalculous Cholecystitis Gallbladder Diseases Biliary Tract Diseases Digestive System Diseases |
ClinicalTrials.gov processed this record on June 18, 2013