Pulmonary Artery Harmonic Ace+7 Energy Sealing in VATS Lobectomy

April 18, 2016 updated by: Centre hospitalier de l'Université de Montréal (CHUM)

Video-assisted thoracic surgery (VATS) anatomical lung resection provides an effective minimally invasive treatment strategy for stage I and II lung cancer. VATS lobectomy is associated with significantly less postoperative atrial fibrillation, blood transfusion, renal failure, and other complications when compared with lobectomy via thoracotomy.

Although VATS lobectomy has been proven to be effective and safe in experienced hands, it is not devoid of risk. Intra-operative surgical complications can be at times catastrophic. Complications include: pulmonary vascular injuries (Pulmonary artery (PA), pulmonary vein) necessitating urgent conversion to open thoracotomy and even death. Causes of conversion included PA injury, difficult anatomy, bulky/calcified lymph nodes, and technical problems including stapler misfire. PA injury alone constituted 37.5% of all conversions. Proper dissection of all tissue around PA branches is sometime difficult especially in the presence of adhesions or large, calcified lymph nodes and may increase the risk of vascular injury.

Currently, in spite of being a safe and effective technique in experienced hands, a minority of anatomical pulmonary resections are being performed by VATS. In an analysis utilizing the Nationwide Inpatient Sample (NIS) database in the United States, only 15% of anatomical lung resections were performed by VATS.

The technical difficulty and danger of VATS lobectomy is directly related to PA branch manipulation, stapling and division. PA manipulation is the main hesitation of many thoracic surgeons regarding the adoption of VATS lobectomy. We believe that if we can decrease the manipulation and dissection required by the surgeon on the PA branches, we can make these procedures safe and therefore more prevalent for anatomical pulmonary resections.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This study consists of evaluating the safety and efficacy of energy sealing lobar PA branches for lobectomy in humans. All patients planned to undergo a lobectomy by VATS at the CHUM - Hôpital Notre-Dame will be approached. In our institution, lobectomies are either done open (thoracotomy) or by minimally invasive approach, known as VATS (video assisted thoracoscopic surgery). This decision is based on the surgeon, tumor size, tumor localization and patient characteristics. Only patients already planned for a VATS lobectomy will be approached. Potential patients will be selected by going over the operation request forms. Patients booked for a VATS lobectomy will be approached either in the preoperative clinic or the day before surgery, when admitted. Aim is to recruit 20 patients.

Study Type

Interventional

Enrollment (Actual)

20

Phase

  • Early Phase 1

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Canada
    • Quebec
      • Montreal, Quebec, Canada, H2L 4M1
        • CHUM-Notre Dame Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • All patients planned to undergo a VATS lobectomy at the CHUM-Hopital Notre-Dame

Exclusion Criteria:

  • Age > 18 years old
  • Inability to consent to the study

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Other: Harmonic Ace+7
Pulmonary artery sealing with Harmonic Ace+7 in VATS lobectomy
Device: HARMONIC ACE+7
Pulmonary artery sealing with Harmonic Ace+7 in VATS lobectomy in humans

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
All patients will be assessed for effective intra-operative pulmonary arterial branch vessel sealing. It will be measured visually by the presence or lack of vessel sealing failure
Time Frame: 30 days

All cases will be videotaped with a thoracosocpic 10 mm, 30 degree camera placed through the chest tube insertion site in order to evaluate the problems in cases of seal failure. All patients will have 4-0 prolene with SH needle ready for use on the sterile field in case there is a sealing failure that needs to be fixed.

Additionally, all patients are routinely crossmatched for 2 units of packed red blood cells (as per standard pre-operative orders).
30 days

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Centre hospitalier de l'Université de Montréal (CHUM)

Collaborators

Centre de Recherche du Centre Hospitalier de l'Université de Montréal

Investigators

  • Principal Investigator: Moishe Liberman, MD, PhD, Centre Hospitalier de l'Université

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

January 1, 2016

Primary Completion (Actual)

April 1, 2016

Study Completion (Actual)

April 1, 2016

Study Registration Dates

First Submitted

December 7, 2015

First Submitted That Met QC Criteria

January 7, 2016

First Posted (Estimate)

January 11, 2016

Study Record Updates

Last Update Posted (Estimate)

April 19, 2016

Last Update Submitted That Met QC Criteria

April 18, 2016

Last Verified

April 1, 2016

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • CE 15.270

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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