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Efficacy Study to Evaluate Laparoscopic Fascial Closure Device

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01024296
Recruitment Status : Completed
First Posted : December 2, 2009
Results First Posted : October 12, 2017
Last Update Posted : October 12, 2017
SurgSolutions, LLC
Information provided by (Responsible Party):
Thomas Krummel, Stanford University

Brief Summary:
During any minimally invasive surgery case, 5-25mm size incisions need to be made to gain access to the abdomen. One of the most difficult, time-consuming, and sometimes unreliable parts of the case is closing these incisions, especially in obese patients. This is mainly because these incisions are very small and the layer that needs to be closed (fascia) rests deep underneath the skin and fat tissue of the abdominal wall. Two of the investigators (CM and BS) have developed at Stanford an instrument that allows for an easier and more reliable closure of these wounds. The purpose of this study is to test this instrument in the closure of laparoscopic wounds in obese patients undergoing laparoscopic gastric bypass surgery.

Condition or disease Intervention/treatment Phase
Hernia, Abdominal Device: Port Close Not Applicable

Detailed Description:

For the patients enrolling in this study, preoperative and postoperative care will be exactly the same. The operative procedure will also be very similar with the only modification being in the way the ports are closed at the end of the surgery and the fact that all ports 11mm or greater will be closed (instead of leaving 11 or 12mm ports to be closed at the discretion of the surgeon). Instead of using a suture-passer to place the suture through the fascia, the surgeon will use the new instrument to drive the suture into the tissue under direct visualization through the umbilical port camera. The same instrument but with new sutures will be used for each of the interrupted stitches that are usually placed to close the port.

The instrument that has been developed by some of the investigators is a 10mm elongated device that can easily be inserted into the port or fascial opening. If inserted through the port, the trocar can then be slid over the instrument to remove the trocar without losing pneumoperitoneum. The instrument has two opposing wings that will open once placed beyond the fascial opening. As the surgeon pulls up on the device, the wings open sliding along the fascia and pushing away any intra-abdominal contents that may be close to the instrument. Once the surgeon assures under direct visualization with the camera that the wings are open at both sides of the wound and that all intra-abdominal contents are out of the way (just as the surgeon would with the standard technique), he or she pushes a plunger that drives two flexible nitinol needles from the shaft of the instrument, through the fascia, and into the wings. The needles will be received in the wings by a set of couplers attached to the same suture that would be used otherwise (#0 Vycril). The surgeon then releases the wings and pulls out the device, leaving a looped suture placed around the opening. The surgeon can then tie the sutures as he or she would normally do on the standard procedure. At any time, the surgeon can reposition or remove the instrument without placing the sutures. The procedure may be repeated as many times as the surgeon considers necessary (usually 1 to close the 11 or 12mm fascial ports and 2 or 3 to close the 25mm fascial port).

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 4 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Pivotal Study to Evaluate the Efficacy of a Laparoscopic Port Closure Device
Actual Study Start Date : July 2009
Actual Primary Completion Date : March 2010
Actual Study Completion Date : March 2010

Arm Intervention/treatment
Experimental: Gastric Bypass Surgery Patients
Surgical site closure using Port Close device
Device: Port Close
Device for applying loop suture to close surgical site

Primary Outcome Measures :
  1. Count of Participants With Successful Port Site Closure Using Port Close Device [ Time Frame: Day 1, at the end of surgery ]
  2. Time of Port Site Closure [ Time Frame: Day 1, from insertion to removal of Port Close device during surgery ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 65 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:- Clinical Diagnosis of Morbid Obesity

  • BMI > 40 or BMI > 35 with medical comorbidities
  • Undergoing laparoscopic gastric surgery
  • Have at least one trocar site measuring 12 mm or greater Exclusion Criteria:Vulnerable subjects will be excluded including:

    1. Children
    2. Pregnant women
    3. Economically and educationally disadvantaged
    4. Decisionally impaired
    5. Homeless people
    6. Employees and students.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01024296

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United States, California
Stanford University School of Medicine
Stanford, California, United States, 94305
Sponsors and Collaborators
Stanford University
SurgSolutions, LLC
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Principal Investigator: Thomas M. Krummel Stanford University
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Responsible Party: Thomas Krummel, Principle Investigator, Stanford University Identifier: NCT01024296    
Other Study ID Numbers: SU-11062009-4361
IRB Protocol #8864 ( Other Identifier: Stanford University )
First Posted: December 2, 2009    Key Record Dates
Results First Posted: October 12, 2017
Last Update Posted: October 12, 2017
Last Verified: September 2017
Additional relevant MeSH terms:
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Hernia, Abdominal
Pathological Conditions, Anatomical